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WCB PLATTEVILLE <br />06/04/01 MON 11:41 FAX 970 785 2590 • <br />• <br />AUTIiORIZATION TO REPRESENT A PARTY <br />(Please Tyne Or Print The Requested Information) <br />SIGNATURES MUST BE IN BLUE INK <br />I, Wl lC~b~ ~ ry K ~ ~ ~~- 0 W !~! ~c2 <br />(Person's Name) (Title) <br />utt(,~ (Q <br />of!!l4.~- G1.G r'Z. syg $ObS 1 (name of company, association, organization, etc.} am <br />authorized to delegate P. Andrew Jones and Kim R. Lawrence, attomevs , <br />(Person's Name) (Consultant, etc.) <br />to represent tlll Cf{ ~ ~~ K. • ~r~GCG~Z_. (name of person, company, association, <br />organization, etc.) at the Pre-hearing Conference and(or Hearing before the Mined Land Reclamation <br />Boazd in this matter. Representative's phone number (970) 356-9160 ,and address <br />1011 11th Avenue , Gree(ev Colorado, 80631 <br />(Street Address) (City) (State) (Zip) <br />SIGNED AND D D TH S / DAY OF ./(i_,i' , . Lam' <br />- ~ ~ .~ <br />' ' C- ~- - ~" ~ ~ oration attest (seal) <br />Autho 'zed Signa a (rFiusr be signed ' ue ink) <br />r <br />Title: <br />STATE OF ~ ~~~ l U ) <br />( )ss. <br />COUNTY OF C ti~ P..~ ~F ) <br />The foregoing instrument was acknowledge before me this ~"~ day of. ~~L." ~~~ I <br />~~ . •............ !~C' <br />~pRY pUB ~ <br />~• BRENDA K. NOTARY PUBLIC <br />i OOENBAUGH•~o <br />N~.. : O _ <br />q •~..,"..•• •• ; ~ R My commission expires: r%~~ ~ 'Ct-L~ <br />lFOF CO~~Q <br />SIGNATURES MUST BE IN BLUE INK <br />r~oo4 <br />