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12/11/2017 Annual Report ePermitting Signup - Google Forms <br />https://docs.google.com/forms/d/1lrxOW3YTBhUqGtqfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNiu21OpoxcJ2G-dyTCZJlj1MruJbfV2o…2/4 <br />PO Box 209 <br />Moffat <br />CO <br />81143 <br />719-256-4447 <br />M-1996-089, M-2013-054 <br />Skoglund <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: *