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12/1/2017 Annual Report ePermitting Signup - Google Forms <br />https://docs.google.com/forms/d/1lrxOW3YTBhUqGtqfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNgjk5IVFjWnubGui0pOQoTYKtIbtMU…2/4 <br />9075 CR 10 <br />Fort Lupton <br />CO <br />80621 <br />303-857-1754 <br />M-2001-107 <br />Zadel <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: *