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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />*� 1313 Sherman Street Room 215 Denver Colorado 80203 h 866 -3567 <br />1876 ` , , , P 303 ) <br />REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA <br />Please indicate if you are requesting: ® RECEIVED <br />FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA <br />ACREAGE REDUCTION (PARTIAL RELEASE) JAN 09 ?014 <br />If you are requesting an acreage reduction, you will need to specify how many acres you wUU$tmltffdWLAMATION <br />from the existing permit under this revision. I wish to release 75.00 acres NlffiWpft&SAFZ-TY <br />You will also need to submit updated mining and reclamation plan maps that accurately depict both the <br />proposed acreage to be released from the current permit area, and the resulting new permit boundary. <br />File No.: M- 1980 -183 Site Name: <br />County: Adams <br />Pit 29 <br />Permittee: Brannan Sand & Gravel Company <br />Operator (If Other than Permittee): <br />Perm ittee Representative: Fred J. Marvel, P . E . <br />Certified Mail# <br />In accordance with Rule 4.17.1(2) the Operator shall include the names, addresses and phone numbers <br />of all owners of record to the affected land. Please attach additional sheets for this information if <br />required. <br />Bromley District Water Users, LLC <br />Robert Lembke <br />8301 East Prentice Ave <br />STE 100 <br />Greenwood Village, CO 80111 <br />303 - 773 -1005 <br />In accordance with Rule 4.17.1(4) the Operator or their agent MUST sign that they have complied with <br />the following statement: "All applicable portions of the Reclamation Plan requirements have been <br />s,.tis€e4 in accordance with these Rules and all applicable requirements under the Act." <br />January 9,2013 <br />re of Pernditee, Operator or their authorized agent Date <br />Important. In accordance with Rule 4.17.1(3)This release request must be submitted to the Division <br />via certified mail and separate from any other correspondence to the Division. <br />