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2025-08-20_GENERAL DOCUMENTS - M1978079
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2025-08-20_GENERAL DOCUMENTS - M1978079
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Last modified
8/21/2025 3:18:50 PM
Creation date
8/21/2025 3:14:06 PM
Metadata
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Template:
DRMS Permit Index
Permit No
M1978079
IBM Index Class Name
General Documents
Doc Date
8/20/2025
Doc Name Note
Epermit Admin Change
Doc Name
Epermitting Administrator Change Form
From
Sara
To
Weimer
Media Type
D
Archive
No
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8/20/25Y 11:48 AM ePermitting Administrator Change Form <br /> Name(s) and Permit Number(s) of any additional person(s) to notify on annual report/map/fee <br /> due date(s): <br /> Tyra Bartuska M-1977-222, M-1981-279, M-1987-079, M-1997-071, M-1999-005, M-2010-012, M-2012-036, <br /> M-2013-0531 M-2014-025, M-2022-024 <br /> .......................................................................................................................................................................................................................................................................................................................................................... <br /> Email address(es) of additional person(s) to notify on annual report/map/fee due date(s): <br /> tyra.bartuska@unitedco.com <br /> _............................................................................................................................................................................ <br /> By clicking "Agree" below, you opt in to ePermitting for report submittal, and consent that the <br /> Division may send any and all correspondence, notices, documents and information to you <br /> electronically, in all matters related to reports and fees for your Permit(s) and/or N01(s). You <br /> further consent that you will use ePermit to send any and all correspondence, notices, <br /> documents and information to the Division in all matters related to reports and fees for your <br /> Permit(s) and/or N01(s). You consent that documents submitted electronically to the Division <br /> have the same legal force and effect as paper documents. The Division reserves the right to <br /> send any or all electronic records to you in paper form to your current mailing address on file at <br /> its sole discretion. Your agreement to opt in to ePermit represents a single legal transaction as <br /> that term is used in C.R.S. § 24-71.3-105. Your agreement to opt into ePermit will become <br /> effective immediately upon the Division's receipt of this signed Agreement and you may no <br /> longer receive paper documents from the Division pertaining to reports and fees for your <br /> Permit(s) and/or N01(s). This Agreement, including the validity of any signatures or consents, <br /> any claims, or any disputes arising hereunder shall be construed in accordance with and <br /> 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 <br /> permittee or N01 holder. <br /> Q Agree <br /> This form was created inside of State.co.us Executive Branch. <br /> Google Forms <br /> https://docs.google.com/forms/d/1 QY6C6w2BMyQoAmu1_DFtS5wVHlfoeUraQePxvehJJac/edit#response=ACYDBNhUY0bU1w3n4DgGsU1 QP03KIb... 3/3 <br />
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