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Permit No. C-80-004 APPENDIX A 13 <br />Signature of Applicant or Authorized Agent <br />The undersigned, being duly sworn, states that he/she has read all the information provided in this <br />application and has found it to be true and correct. <br />Applicant Company Name Lodestar Energy. Inc. <br />Name of Applicant or Agent <br />Whose Signature Appears Below <br />Title <br />Telephone <br />Signature of Applicant or Agent* <br />Subscribed and sworn to before me by <br />This the day of <br />20_ <br />Notary Public <br />My Commission Expires <br />State in which Commissioned <br />*NOTE: If signer is other than president or secretary of a corporation, attach a notarized copy of power <br />of attorney, or resolution of board of directors which grants signer the legal authority to represent the <br />applicant in this application. (Does not apply to a single proprietorship or partnership.) <br />McClane Volume III June, 2002 <br />