2017-11-28_REPORT - M1985082

• Permit No: M1985082
• IBM Index Class Name: Report
• Doc Date: 11/28/2017
• Doc Name Note: Dec 2017 Notice - Fowarded to updated address
• Doc Name: Dec 2017 Notice - Fowarded to updated address
• From: USPS
• To: DRMS / 3B Enterprises, LLC
• 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:
Title:
Name of permittee:
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
(seal)
My Commission expires:
(permittee)
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NOTARY PUBLIC