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2/1/2018 Annual Report ePermitting Signup <br />https://docs.google.com/forms/d/1lrxOW3YTBhUqGtqfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNhCYTyyvX3U8kpux1i3iyizS9OpOqH…2/2 <br />M-183-158-Cadgene Pit <br />MJ Cadgene <br />MJ <br />mjctelluride@hughes.net <br />Agree <br />This form was created inside of State.co.us Executive Branch. <br />Permit/NOI Numbers (ie M-1987-189, P-2016-026): <br />Last Name of individual who will act as account administrator for the ePermitting account: * <br />First Name of individual who will act as account administrator for the ePermitting account: * <br />Email address of account administrator: * <br />The account administrator is responsible for providing the Division with a current email address for ePermitting correspondence. Please contact the Division if <br />an existing administrator email requires updating. <br />By clicking "Agree" below, you opt in to ePermitting for report submittal, and consent that the Division <br />may send any and all correspondence, notices, documents and information to you electronically, in all <br />matters related to reports and fees for your Permit(s) and/or NOI(s). You fur ther consent that you will <br />use ePermit to send any and all correspondence, notices, documents and information to the Division in <br />all matters related to reports and fees for your Permit(s) and/or NOI(s). You consent that documents <br />submitted electronically to the Division have the same legal force and effect as paper documents. The <br />Division reserves the right to send any or all electronic records to you in paper form to your current <br />mailing address on le at its sole discretion. Your agreement to opt in to ePermit represents a single <br />legal transaction as that term is used in C.R.S. § 24-71.3-105. Your agreement to opt into ePermit will <br />become effective immediately upon the Division’s receipt of this signed Agreement and you may no <br />longer receive paper documents from the Division pertaining to reports and fees for your Permit(s) <br />and/or NOI(s). This Agreement, including the validity of any signatures or consents, any claims, or any <br />disputes arising hereunder shall be construed in accordance with and governed by the Laws of the <br />State of Colorado. Further, if the permit or NOI holder is a corporation, partnership, trust, etc., you state <br />that you are authorized to act on behalf of the permittee or NOI holder. * <br /> Forms