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6/16/25Y 9:58 AM ePermitting Signup for New Applications and Annual Reporting <br /> Street Address: <br /> 12600 W Colfax Ave Ste C440 <br /> ............................................................................. <br /> City: <br /> Lakewood <br /> _............................................................................................................................................................................ <br /> State: * <br /> Colorado <br /> _............................................................................................................................................................................ <br /> Zip: <br /> 80215 <br /> _............................................................................................................................................................................ <br /> Telephone: <br /> 970-260-6043 <br /> .............. .......................................................................................................................................... <br /> Currently held Permit/N01 Numbers (ie M1987189, P2016026) <br /> M2009081 <br /> _...................................................................._.................................................................................. <br /> Last Name of individual who will act as account administrator for the ePermitting account: <br /> Clark <br /> _............................................................................................................................................................................ <br /> https://docs.google.com/forms/d/1 IrxOW3YTBhUgGtgfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNinkcUNhN6rntlyzxl5EAzC35CLNOVy... 2/4 <br />