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COLORADO DIVISION 01' RECLA1IAT10N, \LINING AND SAF'FT <br />1 m1 m Sherman street. Room 215. „Iota& sn'ii: ph( :nzi snn-:tet, <br />REQUEST FOR FULL OR PARTIAI. RELEASE OF P <br />Please indicate if you are requesting: (\C1 4� �Q1 <br />FULL FINAI RF1.LASt: OF 1:NTIRt•. PI:RN1ITTL1) ARIA i <br />ACREAGE RLDI:C'TION (PARTIAL L RLl.LASF) ✓1 <br />If you are requesting an acreage reduction. sou w ill need to specil} how mane acres ish to remo'c <br />from the existing hermit under this re% inion. 1 wish to release /6 . 41 acres at this time. <br />You will also need to submit updated minim and reclamation plan maps that accurately depict both the <br />proposed acreage to he released from the current permit arca. and the resulting new permit boundar). <br />File No.: M-2002-020 Site Name.25th Avenue Site <br />('aunty: Weld <br />Permittee:City of Greeley <br />AR02 <br />Operator ( If Other than Permittee): Hall Irwin <br />Permittee Representative: Burt Knight, City of Greeley Water and Sewer Director <br />Certified Mailu 7011 0110 0002 1021 8562 <br />In accordance with Rule 4.17.1(21 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 inliirmation <br />required. <br />Cottonwood Land and Farms, LLC, P.O. Box 229 Boulder CO 80306 (303) 449-1441 <br />%/ Compliance <br />`/ NO Violations <br />In accordance with Rule 4.17.114) the Operator or their agent Mt 'ST sign that they hike complied with <br />the t011ow ing statement: "All applicable portions of the Reclamation Plan requirements ha%c been <br />satisfied in accordanee with these Rules and :ill applicable requirements under the Act." <br />Signature of Permittee, 0 <br />cm " it authorized agent Date <br />Important: In accordance with Rule .1.1- 1(3)Thix release request MUNI he submitted to the Division <br />via certified nail and .separate from any other correspondence to the Division. <br />