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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />*, *" <br />1876 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 866 -3567 <br />REQUEST FOR FULL OR PARTL&L RELEASE OF PERMIT AREA <br />Please indicate if you are requesting: N'i <br />FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA T <br />ACREAGE REDUCTION (PARTIAL RELEASE) <br />DIVISIUN Or WO.h�tiEiN <br />If you are requesting an acreage reduction, you will need to specify how many acreMjN @&Wj t6 hove <br />from the existing permit under this revision. I wish to release N. 0) 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- 2006-080 <br />County: Larimer <br />Site Name: Bokelman- Walters Pit <br />A 9 <br />Permittee: Loveland Ready Mix Concrete, Inc. <br />Operator (If Other than Permittee): <br />Permittee Representative: Stephanie Fancher <br />Certified Mail# 1 012 1010 0000'1612- 4221 <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 />Loveland Ready Mix Concrete, Inc. <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 />sat'sfied in accord ith these Rules and all applicable requirements under the Act." <br />Signa re of Perm &, Operator or their authorized agent Date <br />Important: In accordance with Rule 4.17.16) This release request must be submitted to the Division <br />via certified mail and separate from any other correspondence to the Division. <br />