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* COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> /876*, * 1313 Sherman Street,Room 215,Denver,Colorado 80203 ph(303)866-3567 <br /> 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 release21.80 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- 2001 -069 site Name: Del Norte West Valley Pit <br /> County: Rio Grande <br /> Permittee: Asphalt Constructors, Inc. <br /> Operator(If Other than Permittee): <br /> Permittee Representative: Tiffany Hawkins, Controller <br /> Certified Mail# 7009 2250 0002 1715 6009 <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 /> Mike McDonald - 1445 Bowstring Road, Monument, CO 80132 (719) RICCRUW—lb <br /> 00f F0 14 <br /> Q 0111"..;�'0111 op WLAKra <br /> 4ZNQANDURM <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 /> �t) J-0,-RU k�Ck 10/14/2014 <br /> SJ241re 9f errnittee, 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 />