2017-02-10_GENERAL DOCUMENTS - M2009006

• Permit No: M2009006
• IBM Index Class Name: General Documents
• Doc Date: 2/10/2017
• Doc Name: Agreement to Conduct Permitting by Electronic Means
• From: Colorado Quarry, LLC
• To: DRMS
• Email Name: AME
• Email Name: SLB
• Media Type: D
• Archive: No

Agreement to Conduct Permitting by Electronic Means
Name of permittee representative desiring to
opt in to ePermit:
Title:
Name of permittee:
� 1.6,VuJ'�f
Signature:
ePermitting Administrator (if different from
representative signing agreement)
Email Address for ePermit Account:
Notarized Affidavit of Signature
STATE OF: }
COUNTY OF -ss.
� �� }
The foregoing instrument was acknowledged
before me this , day of by
(date) (month) (year)
as
(Name of permittee representative (title)
of
(permittee)
KELLY N. DOANE
NOTARY PUBLIC ti
STATE OF COLORADO
NOTARY ID # 20044017925 NOTARY P I C
MY COMMISSION EXPIRES 05.24-2020
(seal)
My Commission expires:
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