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Agreement to Conduct Permitting by Electronic Means <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 /> Further, Affiant sayeth not.., <br /> 11:jidL- <br /> iant's name <br /> Signature <br /> Notarized Affidavit of Signature <br /> STATE OF: <br /> COUNTY OF: ) SS. <br /> The foregoing instrument was acknowledged <br /> before me this /A day of by <br /> (date) (month) (year) <br /> as <br /> 111 s Say WA 6 <br /> (Name of permittee representative) (title) <br /> of N <br /> �P�S �� t <br /> (permittee <br /> NOTARY PUBLIC <br /> y� 5i'ATE OF COLORADO <br /> ° NO��ARY D 2006401624t3 N TARY PU LIC <br /> ii MY-,QMfA1"J510•N EXPIRES APRIL186,86,2018 <br /> (seal) <br /> My Commission expires: n4 A/s <br /> Page 5 of 6 <br />