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11/30/2017 Annual Report ePermitting Signup - Google Forms <br />https://docs.google.com/forms/d/1lrxOW3YTBhUqGtqfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNhV8p6dJaVeQ5_NVj4RjP2VvmJTQ…2/4 <br />42538 Co. Rd. 9 <br />Haxtun <br />Colorado <br />80731 <br />970-774-7126 <br />M-2008-072 <br />Carper <br />Street Address: * <br />City: * <br />State: * <br />Zip: * <br />Telephone: * <br />Permit/NOI Numbers (ie M-1987-189, P-2016-026): <br />Last Name of individual who will act as account administrator for the <br />ePermitting account: *