2017-08-04_GENERAL DOCUMENTS - M2001090

• Permit No: M2001090
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 8/4/2017
• Doc Name: Agreement to Conduct Permitting by Electronic Means
• From: Alpine Aggregates, LLC
• To: DRMS
• Email Name: SLB
• Email Name: ACY
• Media Type: D
• Archive: No

Agreement to Conduct Permitting by Electronic Means
Name of permittee representative desiring to
opt in to ePermit: J 4 r1 -e, Ka c 1`t v-+tA u Y'
Title:
Name of permittee: ( p t h �r.e 4 Q 4t5 I W—G
Signature: tt
lima',*Ca�-
ePermitting Administrator(if different from
representative signing agreement)
Email Address for ePermit Account: 4'�f S R22 a� a
Qa�e4
Notarized Affidavit of Sijznature
STATE OF: )
pro coo
COUNTY OF: ) ss.
The foregoing instrument was acknowledged
before me this 3 1 day of by
(date) /- month (year)
as �e l�vl 6 ev,
(Name of permittee representative) (title)
of A14
(permittee)
F-IBE—T—HHEUS GAGNEBIN NOTARY PUBLIC
Notary Public
State of Colorado
Notary ID#19894006744
L——My Commission Expires 05-08-2021
(seal)
My Commission expires:
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