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2/21/2019 Annual Report ePermitting Change Form - Google Forms <br />https://docs.google.com/forms/d/1QY6C6w2BMyQoAmu1_DFtS5wVHIfoeUraQePxvehJJac/edit#response=ACYDBNhiB-cWXG7-4PVxfPxT8SM2RPj…1/3 <br />12 responses <br />Accepting responsesSUMMARYINDIVIDUAL <br />of 12 <br />Responses cannot be edited <br />ePermitting Administrator Change Form <br />* Required <br />Please complete this form to update the ePermitting Administrator for submittal of annual <br />reports and fees. You will receive an email conrming your changes within two business days. <br />Bear Ranch Gravel Mine <br />M2013002 <br />9 <br />Name of Permittee or NOI Holder: * <br />Permit/NOI Numbers (ie M-1987-189, P-2016-026): <br />Annual Report ePermitting Change Form <br />QUESTIONS RESPONSES 12