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19 <br />,COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />" <br />8T 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 866-3567 <br />• • <br />REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT ACEIVED <br />Please indicate if you are requesting: ❑ <br />FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA <br />MAY 15 2015 <br />DMV MN OF RECLWATION <br />��4 <br />ACREAGE REDUCTION (PARTIAL RELEASE) ✓ 4 � PAPHNG AND SAF EW <br />If you are requesting an acreage reduction, you will need to specify' �,xacres you wish to remove <br />from the existing permit under this revision. I wish to release r�J acres at this time. <br />You will also need to submit updated mining and reclamation plan maps that accurately depict both the <br />proposed gCreage to be released from the current permit area, and the resulting new permit boundary. <br />File No.: M- 2002-109 Site Name Cucharas Pit <br />County: <br />Huerfano <br />0,Permittee:A. Blasi & Son Trucking & Earthmoving LLC. <br />Operator (If Other than Permittee): <br />Permittee Representative: An t h o n y Blasi <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 />Jim Pace <br />603 W. Calle De Caballos <br />Pueblo West, CO 81007-1892 <br />719-547-1037 <br />V P f= d- 4 <br />✓ �/i?1/Q�(GNS' i 1x660« <br />abr,W6 <br />rYJ V 0/ 301;7 <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 />Signatur�mittee, Operator or their Aluthorized agent <br />05/12/2015 <br />Date <br />Important: In accordance with Rule 4.17.1(3)This release request must be submitted to the Division <br />"1 - - --'-UT -'1 --- -21 --- .1 - -- ---A - �' - -.. -•1- " <br />