PERMFILE61522

• Permit No: M2001001
• IBM Index Class Name: Permit File
• Doc Date: 4/10/2001
• Doc Name: NOTICE TO THE PARTIES & INTERESTED PERSONS OF THE LINE CAMP PIT APPLICATION
• Media Type: D
• Archive: No

AUTHORIZATION TO REPRESENT A PARTY
(Please Tvpe Or Print The Requested Information)
SIGNATURES M1IUST 6E IN BLUE INK
I
(Person's Name)
of
authorized to delegate
(Tidz)
(name of company, association, organization, etc.) am
a
(Person's Name) (Consultant, etc.)
to represent (name of person, company, association,
organization, etc.) at the Pre-hearing Conference and/or Hearing before the Mined Land Reclamation
Borad in this matter. Representative's phone number ( ) - ,and address
(Streit Address)
SIGNED AND DATED THIS
(City)
DAY OF
Authorized Signature (must be signed in blue ink)
STATE OF
(State) (ZIP)
If corporation attest (seal)
ss.
COUNTY OF )
The foregoing instrument was acknowledged before me this day of
bv_ as
of
NOTARY PUBLIC
My Commission ex
SIGNATURES MUST BE IN BLUE INK
AI"ovlpmmUwftonxminn m Rrpresem a Pan y.doc