2019-09-10_PERMIT FILE - P2019011

• Permit No: P2019011
• IBM Index Class Name: Permit File
• Doc Date: 9/10/2019
• Doc Name: Notice Of Intent
• From: DRG Mining LLC
• To: DRMS
• Email Name: DMC
• Email Name: THM
• Media Type: D
• Archive: No

1.the undersigned,being the NO[holder or the person authorized to sign-an-behalf of the N01
holder,declare that the information given in this NO[ form is true and correct.
SIGNATURES MUST BE IN BLUE INK
Signed and dated this �� day of ��.P�, EyJ � 19
( ate) (mono) y ar)
Signature of NO[holder or person authorized to sign:
Name(typed or printed): _A A Co!Ej_ W iL�C��1 Sb N
Title/Position: MLM K7 E
li
M:\min\oss\slh\MineralsForms\ProspectForm2
30 Aug 2017
Form 2 Public File page 14 of 14