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8/15/22,8:10 AM Annual Report ePermitting Signup <br /> Annual Report ePermitting Signup <br /> C 0 L 0 R A D 0 <br /> Division f Reclamation,, <br /> TR+ <br /> F Mining and Safety <br /> Department of Natural Resources <br /> Please complete this form to create a new ePermitting account for submittal of annual reports <br /> and fees. You will receive an email with your login information within two business days. This <br /> form is for new ePermitting account activation. If you have already enrolled in ePermitting, you <br /> should not complete this form. <br /> Name of Permittee or N01 Holder: <br /> Dianna Kay Mouse <br /> ......................................................................................................................................................................................................................................................................................................................................................... <br /> Street Address: <br /> P.O. Box 601 <br /> https://docs.google.com/forms/d/1 IrxOW3YTBhUgGtgfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNg6Ye_5Pi2x7WQ9uxbZDn6gtkddJo... 1/4 <br />