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12/5/2019 Annual Report ePermitting Change Form-Google Forms <br /> QUESTIONS RESPONSES <br /> 76 responses <br /> SUMMARY INDIVIF" I A I Accepting responses • <br /> 76 of 76 � ■ <br /> Responses cannot be edited <br /> ePermitting Administrator Change Form <br /> Required <br /> COLORADO <br /> Dliv,ision of Reclamation,, <br /> TA4. I M�ning and, Safety <br /> Department of 1atural Resaurces <br /> Please complete this form to update the ePermitting Administrator <br /> for submittal of annual reports and fees. This form is for changing <br /> the name and/or email address of the administrator on existing <br /> ePermitting accounts. You will receive an email confirming your <br /> changes within two business days. <br /> https://docs.google.com/forms/d/l QY6C6w2BMyQoAmu1—DFtS5wVHlfoeUraQePxvehJJac/edit#response=ACYDBNi2dj-LpxDpuMO-XX7PcYdTAQba... 1/4 <br />