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5/20/24,9:08 AM ePermitting Administrator Change Form <br /> ePermitting Administrator Change Form <br /> Email <br /> ben@a proag.farm <br /> OR <br /> C0L %0% <br /> A """" OL)" 00*61 <br /> Division of Rclaam <br /> Mining and Safety <br /> Department of a -ral 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 /> Progressive Agricultural Management <br /> https://docs.google.com/forms/d/1 QY6C6w2BMyQoAmu1_DFtS5wVHlfoeUraQePxvehJJac/edit#response=ACYDBNiXM_vR57ka000hXHyRb4KnR... 1/3 <br />