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3/3/2020 Annual Report ePermitting Signup-Google Forms <br /> Please complete this form to create a new ePermitting account for submittal of annual <br /> reports and fees. You will receive an email with your login information within two business <br /> days. This form is for new ePermitting account activation. If you have already enrolled in <br /> ePermitting, you should not complete this form. <br /> Name of Permittee or NOI Holder: <br /> Eagle Rocks Aggregate, Inc. <br /> ............................................................................................................................................................................... <br /> Street Address: <br /> 100 Airport Road <br /> ................................................................................................................................................................................ <br /> City: <br /> Gypsum <br /> ................................................................................................................................................................................ <br /> State: <br /> Colorado <br /> Zip: * <br /> 81631 <br /> Telephone: * <br /> (970) 524-7625 <br /> https://docs.google.com/forms/d/1 IrxOW3YTBhUgGtgfeXDsKSGkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNiO4cgxyWxoWkWQangFwfiBxQOZO... 2/4 <br />