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Agreement to Conduct Permitting by Electronic Means RECEIVED <br /> AUG 2 4 2018 <br /> Name of permittee representative desiring to DIVISION OF REC!AMATION <br /> opt in to ePermit: MINING&SAFETY <br /> Name of permittee: 0-DL-bP_A �L -A f-3AjTE t� <br /> �,4 M(_L�/ 1)tg <br /> Title: 2 <br /> Signature: <br /> Email Address for ePermit Account: <br /> Cv I n 1/1 f?S Cal O 1rCLG(-a c- 0.L l�t�+P►�', (� �Vvl <br /> Notarized Affidavit of Signature <br /> STATE OF: ,; ) <br /> COUNTY OF: ) ss. <br /> The foregoing instrument was acknowledged <br /> before me this 3 t4 day of ' Q by <br /> (date) (year) <br /> as <br /> (Name of permittee representative) (title) <br /> of <br /> (permittee) <br /> BARBARA R HEWER <br /> NOTARY PUBLIC NOTARY PUBLIC <br /> STATE OF COIARADO <br /> NOTARY ID 20004019M <br /> MY COMMISSION EXPIRES 02b71= <br /> (seal) <br /> My Commission expires: <br /> 7-1 <br /> D o <br /> Page 3 of 4 <br />