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8/26/24Y 11:45 AM Annual Report ePermitting Signup <br /> Name(s) and Permit Number(s) of any additional person(s) to notify on annual report/map/fee due date(s): <br /> _........................................................................................................................................................................................................................................ <br /> Email address(es) of additional person(s) to notify on annual report/map/fee due date(s): <br /> _........................................................................................................................................................................................................................................ <br /> By clicking "Agree" below, you opt in to ePermitting for report submittal, and consent that the Division may send any and all <br /> correspondence, notices, documents and information to you electronically, in all matters related to reports and fees for your <br /> Permit(s) and/or N01(s). You further consent that you will use ePermit to send any and all correspondence, notices, documents <br /> and information to the Division in all matters related to reports and fees for your Permit(s) and/or N01(s). You consent that <br /> documents submitted electronically to the Division have the same legal force and effect as paper documents. The Division <br /> reserves the right to send any or all electronic records to you in paper form to your current mailing address on file at its sole <br /> discretion. Your agreement to opt in to ePermit represents a single legal transaction as that term is used in C.R.S. § 24-71.3-105. <br /> Your agreement to opt into ePermit 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 for your Permit(s) and/or N01(s). <br /> This Agreement, including the validity of any signatures or consents, any claims, or any disputes arising hereunder shall be <br /> construed in accordance with and governed by the Laws of the State of Colorado. Further, if the permit or N01 holder is a <br /> corporation, partnership, trust, etc., you state that you are authorized to act on behalf of the permittee or N01 holder. <br /> 0 Agree <br /> This form was created inside of State.co.us Executive Branch. <br /> https://docs.google.com/forms/d/llrxOW3YTBhUgGtgfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNgzeilMW6dSBbVNawrfYD1IAYrpj-8RpM2J4KEKBOUm-Act BmJSt3Z07kbCeBxWAE 4/5 <br />