My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2017-10-23_GENERAL DOCUMENTS - M2006059
DRMS
>
Day Forward
>
General Documents
>
Minerals
>
M2006059
>
2017-10-23_GENERAL DOCUMENTS - M2006059
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
1/6/2021 7:16:51 AM
Creation date
10/24/2017 10:46:13 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2006059
IBM Index Class Name
GENERAL DOCUMENTS
Doc Date
10/23/2017
Doc Name
Agreement to Conduct Permitting by Electronic Means
From
Continental Divide Ranch
To
DRMS
Email Name
LJW
SLB
Media Type
D
Archive
No
Tags
DRMS Re-OCR
Description:
Signifies Re-OCR Process Performed
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
7
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Agreement to Conduct Permitting by Electronic Means <br /> Name of permittee representative desiring to �� J <br /> opt in to ePermit: 1 -0 <br /> Title: {�/ <br /> Name of permittee: ,7 �� ���\ I ���,�ch k pi +jr u <br /> Signature: <br /> ePermitting Administrator(if different from <br /> representative signing agreement) <br /> Email Address for ePermit Account: /^on Ir&t I /IQ SZ yti hoo c o ,- <br /> Notarized Affidavit of Signature <br /> STATE OF: ) <br /> C�1or�y <br /> COUNTY OF: ) ss. <br /> ra�ai�c� <br /> The foregoing instrument was acknowledged <br /> before me this �--V " day of by <br /> (date) (month) (year) <br /> — as <br /> �Kn�( <br /> (Name of permittee repres ntative) (title) <br /> of <br /> 0,.(-)f1A,t m IM G\o ,mar 1� PLC_ <br /> (permittee) <br /> LUCIA TERRIQUEZ <br /> NOTARY PUBLIC NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20144000136 <br /> MY COMMISSION EXPIRES JANUARY 2,2018 <br /> (seal) <br /> My Commission expires: <br /> Page 3 of 6 <br />
The URL can be used to link to this page
Your browser does not support the video tag.