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5/21/2020 Coal Program ePermitting Signup-Google Forms <br /> Please complete this form to create a new ePermitting account to access ePermitting forms. <br /> You will receive an email with your login information within two business days. This form is for <br /> new ePermitting account activation. If you have already enrolled in ePermitting, you should <br /> not complete this form. <br /> Name of Permittee: <br /> Blue Mountain Energy, Inc. - Deserado Mine <br /> ............................................................................................................................................................................... <br /> Street Address: ' <br /> 3607 County Road 65 <br /> City: * <br /> Rangely <br /> ................................................................................................................................................................................ <br /> State: <br /> Colorado <br /> Zip: <br /> 81648 <br /> ................................................................................................................................................................................ <br /> Telephone: <br /> 970-675-4322 <br /> https://docs.google.com/forms/d/1 kFaOUGYvnegHl8rVn6BXL7_wkTUQtHPvUij8w6F_MaE/edit#response=ACYDBNg6GY5Dv1 URGVtBP2wJ2aPiiNK... 2/4 <br />