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P �V OF COCO'9 <br /> h\V <br /> mow_. ` <br /> *" COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> 1313 Sherman Street,Room 215,Denver,Colorado 80203 ph(303)866-3567 <br /> 1876 <br /> �}- 6� .L REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA <br /> Please indicate if you are requesting: <br /> FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA <br /> ACREAGE REDUCTION (PARTIAL RELEASE) <br /> If you are requesting an acreage reduction, you will need to specify how many acres you wish to remove <br /> from the existing permit under this revision. I wish to release 1.47 acres at this time. <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- 1 978-078 Site Name: Pickenpaugh Gravel Pit <br /> County: Lincoln <br /> Permittee: Lincoln County <br /> Operator(If Other than Permittee): <br /> Permittee Representative:John DeWitt <br /> Certified Mail# G/ 2- Z Z Zf% M�;2 -5-7G 3 7 <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 /> CHARLES BREWER <br /> 12501 COUNTY ROAD 11.6 <br /> RAMAH, CO 80832 <br /> 719-446-5429 <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 /> satisfied in accordance with these Rules and all applicable requirements under the Act." <br /> Z- 3 <br /> Signature of P rmi ee Operator or their authorized agent Date <br /> g Pe g <br /> Important: In accordance with Rule 4.17.1(3)This release request must be submitted to the Division <br /> via certi aed mail and separate from any other corres ondence to the Division. <br />