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James D. Branch <br /> Page 2 of 2 <br /> August 23,2017 <br /> Agreement to Conduct Permitting hi Electronic Afeans <br /> Fame of permittee rcoresn tam desiring to <br /> opt in to epermit: James D. Branch <br /> Name of H R 1 Sound Repair <br /> Titlr. <br /> Signature: <br /> Email Address for ePermit Account: �` S <br /> Notarized Affidavit of Signature <br /> STATE OF: } <br /> COUNTY OF: ) ss. <br /> The foregoing instrument was acknowledged <br /> before me this 8 1 T,, day of oo n by <br /> (date) (year) <br /> �YrAS 0 �YC3.rc,t_ a5 61.�J,n.Qf <br /> (Name of permittee representative) (title) <br /> of HCR High Country Repair <br /> etoz-co-ro ssnc•3 -�e�y (permittee) <br /> zosetoostot. <br /> r opakolo:)p> <br /> 2IIOnd jet'! <br /> "380100113dINN3i aN V1dN — <br /> T,'OT Y PUBLIC <br /> (seal) <br /> My Commission expires: <br /> tQ <br /> Page 3 of 4 <br />