Laserfiche WebLink
AUTHORIZATION TO REPRESENT A PARTY RECr!1Vr--!) <br /> (Please Type Or Print The Requested Information) DEC 2 32018 <br /> Division of ReciamatloA, <br /> SIGNATURES MUST BE IN BLUE INK Mining&Safety <br /> 1 MASK <br /> (person's name) (tide) <br /> Of*-V 2 Q N Y C A---O a i„m s' i-jr(name of company,association,organization,etc.)am <br /> authorized to delegate M A R,tc t-f �n�z 2 , a ,— <br /> (person's name) (consultant, etc.) <br /> to represent7-t/ r cA--,O-.- CqL Ar Lti-� (name of person, company, association, organization, <br /> etc.) at the Pre-hearing Conference and/or Hearing before the Mined Land Reclamation Board in <br /> this matter. <br /> SIGNED AND DATED THIS2 G DAY OF ce M�c R <br /> If corporation attest(seal) <br /> Authorized Signature(must be signt— <br /> State blue ink) <br /> Title: (/t c i, ,�of C(Q u� o ) <br /> )ss <br /> County of �� � � ) <br /> The foregoing instrument was acknowledged before me this b� day of 1%YkA <br /> by l !?K. `L, (hCIA a"`( as I of ( ► OtJ QU,A40-1 LNL . <br /> ERIC S HOWARD <br /> Notary Public a-,u <br /> State of Colorado <br /> Notary 1D a 20144021884 Notary Puyb�liicl� <br /> My Commission Expires 05 30 2022 My commission expires: 1t��"1-1 36, <br /> SIGNATURES MUST BE IN BLUE INK <br /> AAblkdoc\prtywve.wp <br />