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5/10/24, 11:00 AM ePermitting Administrator Change Form <br /> ePermitting Administrator Change Form <br /> Email * <br /> Bryan.Jorgensen@kiIgorecompanies.com <br /> ............................................................................................................................................................................. <br /> C 0 L 0 A 0 <br /> Division of Reclamation,, <br /> tM Mining and Safety <br /> Department of Natural resources <br /> Please complete this form to update the ePermitting Administrator for submittal of annual <br /> reports and fees. This form is for changing the name and/or email address of the administrator <br /> on existing ePermitting accounts. You will receive an email confirming your changes within two <br /> business days. <br /> Name of Permittee or N01 Holder: <br /> Northwest Aggregates, Inc. <br /> https://docs.google.com/forms/d/1 QY6C6w2BMyQoAmu1_DFtS5wVHlfoeUraQePxvehJJac/edit#response=ACYDBNgDAM2iM_ZO9-he3QZ-DLhCTIp... 1/3 <br />