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10/25/2019 Annual Report ePermitting Signup-Google Forms <br /> 4nnual Report ePermitting Signup <br /> QUESTIONS RESPONSES 1,080 <br /> 1,080 responses <br /> SUMMARY Accepting responses • <br /> 1080 of 1080 ■ <br /> Responses cannot be edited <br /> Annual Report ePermitting Signup <br /> R e q Lli�",q d <br /> COLORADO <br /> Division of l atio , <br /> TIA Mining and Safety <br /> Department of Natural Rcsou-rces <br /> Please complete this form to create a new ePermitting account for submittal of annual reports <br /> and fees. You will receive an email with your login information within two business days. This <br /> form is for new ePermitting account activation. If you have already enrolled in ePermitting, you <br /> should not complete thi-q form. <br /> Name of Permittee or NOI Holder: <br /> 2nd Generation Mining LLC <br /> ......................................................................... ...................................................................................................................... <br /> Street Address: <br /> 11786 Shadow Trail Dr.SW <br /> I.............................................. <br /> h ttp s://d o cs.g o o g I e.co m/fo rm s/d/11 rxOW3YT B h U q G tq feX D s K5 G kvVj w_j F E-9j m i KZ U R F s/e d i t#re s p o n s e=ACY D B N g E zTo H Z 11 h rU AX 7 d I a S c k-vJ xq Vg S... 1/3 <br />