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11/13/245 2:27 PM ePermitting Signup for New Applications and Annual Reporting <br /> Name of Permit Applicant, or existing Permittee or N01 Holder: <br /> Tim Brown <br /> ........................................................................................................................................................................................................ <br /> Street Address: * <br /> 142 El Dorado Drive <br /> _........................................................................................................................................................................................................................................ <br /> City: <br /> South Fork <br /> _........................................................................................................................................................................................................................................ <br /> State: <br /> Colorado <br /> _........................................................................................................................................................................................................................................ <br /> Zip: <br /> 81154 <br /> _........................................................................................................................................................................................................................................ <br /> https://docs.google.com/forms/d/llrxOW3YTBhUgGtgfeXDsKSGkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNgRFKzpizQwHp9EY0jXgfArvQm7C712VYhhzQ3ye4ywAkM2C2CXzUoHJ1-nggEfQdM 2/5 <br />