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11/1/22, 12:15 PM Annual Report ePermitting Signup <br /> Street Address: <br /> 17448 CR 501 <br /> ......................................................................................................................................................................................................................................................................................................................................................... <br /> City: * <br /> Bayfield <br /> State: <br /> CO <br /> ......................................................................................................................................................................................................................................................................................................................................................... <br /> Zip: * <br /> 81122 <br /> Telephone: <br /> 970-759-2804 <br /> Permit/N01 Numbers (ie M-1987-189, P-2016-026): <br /> M1980143 <br /> ......................................................................................................................................................................................................................................................................................................................................................... <br /> Last Name of individual who will act as account administrator for the ePermitting account: <br /> Valencia <br /> https://docs.google.com/forms/d/1 IrxOW3YTBhUgGtgfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNhfzgQHtX7fhZc4hwFd7tScKWiyPnC... 2/4 <br />