2018-03-06_GENERAL DOCUMENTS - M1997087

• Permit No: M1997087
• IBM Index Class Name: General Documents
• Doc Date: 3/6/2018
• Doc Name Note: Agreement to Conduct Permitting by Electronic Means
• Doc Name: Agreement to Conduct Permitting by Electronic Means
• From: Arnold's Custm Seeding, LLC
• To: DRMS
• Email Name: SLB
• Email Name: ERR
• Media Type: D
• Archive: No

3037320510
Agreement to Conduct Permitting by Electronic Means
Name of permittee representative desiring to
dpt in to ePermit:
Title:
Name of permittee:
Signature:
ePermitting Administrator (if different from
11:33.23 a.m. 03-06-2018 415
00
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representative signing agreement) LSA—
Email Address for ePermit Account: F— Full—l~Z @��� ��• CCA&
Notarized Affidavit of5ignature
STATE OF: /t )
COUNTY OF:
The foregoing instrument was acknowledged
before me this 2) day of 7-015 by
(date) I (month) (year)
s ti ( as 6krlpkoi .,e
(Name ofperndttee representative) (title)
P IA..A CARLSON::
btarY Pub tic
S Id'ofCw0fild5412.'
Qn EoP fes 10i110-4420
My Commission expires:
l 0 3 Zoz-u
of
(permittee)
Page 3 of 6
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