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1/4/2018 Annual Report ePermitting Signup - Google Forms <br />https://docs.google.com/forms/d/1lrxOW3YTBhUqGtqfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNipTOHo2bxaImOolCrloRKX8e3ilZXp…2/4 <br />32416 US Hwy 34 <br />Wray <br />CO <br />80758 <br />970-332-4613 <br />M-2008-030,M-1982-218 <br />Sandquist <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: *