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Agreement to Conduct Permitting by Electronic Aleans <br /> Name of permittee representative desiring to <br /> opt in to ePermit: ���,.� ►1J1• (�1e,�e4 <br /> Title: <br /> P-e; ed- a..� G�'y1 B✓Y�� �D'c'�5�� <br /> Name of permittee: 0 1� ;� �� 1-1- <br /> Signature: <br /> ePermitting Administrator(if different from <br /> representative signing agreement) <br /> Email Address for ePermit Account: <br /> Notarized Affidavit of Si nature <br /> STATE OF: <br /> COUNTY OF: ) ss. <br /> The foregoing instrument was acknowledged <br /> before me this 1,1 r� day of jti 1 2 1 7 by <br /> (date) (m (year) <br /> as <br /> 11 lell"�0� C-xe&h--,ve. V,�� ►ie�,v�c✓cf" ���� ce�����fog +sal <br /> (Name of permittee representative) (title) <br /> of q <br /> 0 71 ri� LG <br /> (permi ee) <br /> am4" im <br /> NOTARY PUBLIC <br /> ;a CHRISTINE M.DAVIS <br /> I.- <br /> a_ My Notary ID#129330339 <br /> (seal) •. ... +;� Expkes March 4,2021 <br /> My Commission expires: / <br /> Page 3 of 6 <br />