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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />I +I ; Sherman Street. Room MI5. Ikmet. ( ,)lota& 5U20: ph( 303) tin( -:fit,' <br />REOI'ES'I' FOR FULL OR PARTi•A1. RELEASE OF PW101111 <br />pGi <br />oMria <br />0414 <br />If you are requesting an acreage reduction..xou 1\ ill need to specil how many acres yttu 's ish to remine <br />from the existing permit under this roti tsion I \t,sh to release /6 . 4, acres at this time. <br />You will also need to submit updated nun,ng 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 houndarti. <br />File 10 • M 2002-020 Site Name. 25th Avenue Site <br />Please indicate if you are requesting: <br />FULL. FINAL RELEASE OF I:NTIRI'. PERMITTED AREA <br />AC'RI:A(il: REDUCTION (PART1A1. IRLLEASF) <br />county:Weld <br />Permittee: City of Greeley <br />AR02 <br />Operator (if Other than Permittee): Hall Irwin <br />Permittee Representati\ e: Burt Knight, City of Greeley Water and Sewer Director <br />Certified Mail u 7011 0110 0002 1021 8562 <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 liar this information if <br />required. <br />Cottonwood Land and Farms, LLC, P.O. Box 229 Boulder CO 80306 (303) 449-1441 <br />V Compliance <br />/ NO Violations <br />In accordance with Rule 4.17.1(4) the Operator or their agent MI. 5'1 sign that they has c complied with <br />the following statement: "All applicable portions of the Reclamation Plan requirements has e been <br />satisfied in accordance with these Rules and all applicable requirements under the Act." <br />Signature of Permittee, 0 <br />4111WIPr authorized agent Date <br />Important: In accordance with Rule -!.1 -.1(3)This release request must he submitted to the Division <br />ria certified mail and separate from ant' other correspondence to the i)ivi.sion. <br />