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4 <br /> �C� Agreement to Conduct Permitting by Electronic Means I� Dk <br /> 5. Affiant will inform the Division of Reclamation Mining and Safety within thirty <br /> (30) days in the event that his/her authorization to execute ePermitting Documents <br /> on the Company's behalf is terminated. <br /> 1?Further, Affiant sayeth not. DEC <br /> DNIS/ON Or <br /> C a e to Fr t pS0n MIN/N(;gN�,,,,ANgTIQN <br /> Affiant's name ETy <br /> Signature <br /> Notarized Affidavit of Signature <br /> STATE OF: ) <br /> COUNTY OF: ) ss. <br /> The foregoing instrument was acknowledged <br /> before me this 7 day of r� , //J by <br /> (date) (month) (year) <br /> (Name of permittee representative) (title) <br /> of L <br /> (permittee) <br /> MARY DEWEESE <br /> NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20084036833 NOTA1W PUBLIC <br /> MY COMM.EXPIRES NOVEMBER 13,2020 <br /> (seal) <br /> My Commission expires: <br /> Page 5 of 6 <br />