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1/28/26Y 8:56 AM ePermitting Sign-up for New Applications and Annual Reporting <br /> Currently held Permit/N01 Numbers (ie M1987189, P2016026) <br /> M1980244 <br /> ............................................................................................................................................ <br /> Last Name of individual who will act as account administrator for the ePermitting account: <br /> Crawford <br /> _............................................................................................................................................................................ <br /> First Name of individual who will act as account administrator for the ePermitting account: <br /> Brian <br /> _............................................................................................................................................................................ <br /> Email address of account administrator: <br /> The account administrator is responsible for providing the Division with a current email address for <br /> ePermitting correspondence. Please contact the Division if an existing administrator email requires <br /> updating. <br /> brian.crawford@CCVmining.com <br /> _........................................................................... ............................................................................................ <br /> Name(s) and Permit Number(s) of any additional person(s) to notify on annual report/map/fee <br /> due date(s): <br /> _............................................................................................................................................................................ <br /> Email address(es) of additional person(s) to notify on annual report/map/fee due date(s): <br /> _............................................................................................................................................................................ <br /> https://docs.google.com/forms/d/1 IrxOW3YTBhUgGtgfeXDsK5GkvVjw_jFE-9jmiKZURFs/edit#response=ACYDBNhxhTNGkQfe05lA1 BzMAKe9K5wnz... 3/4 <br />