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~04!12/Ol 11:52 $9705581111 TBE LAW BUILDING ~ 002/002 <br />-- - <br />999 <br />AUTHORIZATION TO REPRESENT A PARTY <br />(Please Tvpe Or Print The Reguesred Information) <br />S1GN,tTVRES bIUST BE LY atUE lir7: <br />I MICHAEL J. PTASNIK N/A <br />(Pcnori s Name) CCitle) <br />Of N/A <br />(name of company, associa[ion. organization, etc.) am <br />Kim R. Lawrence and <br />authorized to delegate f - Andrew pones an Attorney <br />(Person i Name) (Consultant, etc.) <br />CO reprCSenf __ I~7ICHTFr. .T. PTASt7ItL (name of person. company, as50ClaC10n. <br />organization, etc.)'at the Pre-hearing Conference and/or Hearing before the Mined Land Reclamation <br />Borad in this matter. Representati~a's phone number (970) 3 sh - 91fi0 ,and address <br />10].1 11th Avenue Greeley CU 60631 <br />(Street Addttss) ~ (City) (Swte) ~ (Z[P) <br />SIGNED AND DAT'Eb T,ffi.,5,,,_~ •!} a-i`I'1 DAY OF 1~ nri I . ~_. <br />"~L""~""'~ ~ ' ^- "`^- If corporation guest (seal) <br />puthorlmd Signature (nWtr a tigned in blue ink) <br />STATE OF ('>-~I C~l~ d r7 ) <br />couNTY of `.D P,n~ Lr ~ ~'~ <br />The Forcgoino inawment was acknowledged before me this ,y~yU„day of ~ f_I ~ t cJ0~1 <br />~r'~ . <br />by mIC{'1Q2I J. P~"lLSnr IC... ~ ~ cf <br />NOTARY P[)HLIC <br />My Commission expire:: 7 ~ 3 <br />^ SLGNa7URES iNVST BE Lr BLUE DJf: <br />