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10/2/2018 Annual Report ePermitting Signup - Google Forms <br />https://docs.google.com/forms/d/1lrxOW3YTBhUqGtqfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNiOcbiVcx39FbxL9PR08TiTF00-_VN…1/3 <br />828 responses <br />Accepting responsesSUMMARYINDIVIDUAL <br />of 828 <br />Responses cannot be edited <br />Annual Repor t ePermitting Signup <br />* Required <br />Please complete this form to create an ePermitting account for submittal of annual reports <br />and fees. You will receive an email with your login information within two business days. <br />Liberty Mining, LLC <br />1300 South Highway 191 <br />828 <br />Name of Permittee or NOI Holder: * <br />Street Address: * <br />Annual Report ePermitting Signup <br />QUESTIONS RESPONSES 828