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5-21-Ott1:32AM; NEW DESIGN :3032B6995B # 2/ 2 <br />- • <br />AUTHORIZATION TO REPRESENT :~ PARTY <br />(Please Tvpe Or Print The Requested Information) <br />SIGNATURES MUST BE LV BLCE LVIi <br />I ~~G ti ~r-i L' ~ L7/~F/Ud /9'tJ6 .~ <br />(Person's Name) (Title) <br />of <br />(name of company, association, organization, etc.) am <br />authorized to delegate ~p~-: i'a {~-rw , a ~ffoiirry <br />(Person's Name) (Cons ant, etc.) <br />to represent ~-~aa /.__ ~ . ()QErUd,4lIG L!(name of person, company, association, <br />organization, etc.) at the Pre-hearing Conference and/or Hearing before the Mined Land Reclamation <br />Borad in this matter. Representative's phone number (303) 2 46 - X14/ 2 ,and address <br />_1 X14/ E;a[k.,l-I ~r~-.T L7rnlvts- ~e/ci _.P'bLoz-l2SS <br />(Street Addr- e~ ~ (City) (State) (ZIP) <br />SIGNED AND DATED THIS Z /DAY OF ~ L v o , <br />~~--/ r If corporation a[ust (seal) <br />A otized Sign re (must be signed in blue r) <br />1 <br />STATE OF I.Q QA D O <br />COUNTY OF_ f \~ (a fn S ) ss. <br />n S-1 <br />The foregoing instrument was acknowled¢ed before me this ~l~ day of a-00 ~ , <br />SIGNATURES h1UST BE IN BLUE INK <br />