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5/10/22,9:12 AM ePermitting Administrator Change Form <br /> Email address(es) of additional person(s) to notify on annual report/map/fee due date(s): <br /> j.walker@holcim.com, wyatt.webster@lafargeholcim.com <br /> ......................................................................................................................................................................................................................................................................................................................................................... <br /> By clicking "Agree" below, you opt in to ePermitting for report submittal, and consent that the <br /> Division may send any and all correspondence, notices, documents and information to you <br /> electronically, in all matters related to reports and fees for your Permit(s) and/or NOI(s). You <br /> further consent that you will use ePermit to send any and all correspondence, notices, <br /> documents and information to the Division in all matters related to reports and fees for your <br /> Permit(s) and/or NOI(s). You consent that documents submitted electronically to the Division <br /> have the same legal force and effect as paper documents. The Division reserves the right to <br /> send any or all electronic records to you in paper form to your current mailing address on file <br /> at its sole discretion. Your agreement to opt in to ePermit represents a single legal <br /> transaction as that term is used in C.R.S. § 24-71.3-105. Your agreement to opt into ePermit <br /> will become effective immediately upon the Division's receipt of this signed Agreement and <br /> you may no longer receive paper documents from the Division pertaining to reports and fees <br /> for your Permit(s) and/or NOI(s). This Agreement, including the validity of any signatures or <br /> consents, any claims, or any disputes arising hereunder shall be construed in accordance <br /> with and governed by the Laws of the State of Colorado. Further, if the permit or NOI holder <br /> is a corporation, partnership, trust, etc., you state that you are authorized to act on behalf of <br /> the permittee or NOI holder. <br /> QAgree <br /> This form was created inside of State.co.us Executive Branch. <br /> Google Forms <br /> https://docs.google.com/forms/d/1 QY6C6w2BMyQoAmu1_DFtS5wVHIfoeUraQePxvehJJac/edit#response=ACYDBNhvrWunOZYuWPpflpP_3vteDNne... 3/3 <br />