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DIVISION OF RECLAMATION, MINING AND SAFETY <br />Release Notices Checklist <br />Date: 11/05/2015 <br />Permit No.: M-1977-081 <br />Site Name: Greeley West Pit <br />Permittee: City of Greeley <br />Specialist: Amy Eschberger <br />❑ ♦ County Commissioners <br />Specify County: <br />❑ ♦ Soil Conservation District <br />Specify SCD: <br />❑ ♦ Land Owner(s) <br />Name: <br />Address: <br />Name: <br />Address: <br />Weld County <br />West Greeley <br />Cottonwood Land and Farms, LLC <br />P.O. Box 229 <br />Boulder, CO 80306 <br />City of Greeley <br />1100 10th Street, Suite 300 <br />Greeley, CO 80631 <br />❑ ♦ Water Resources (If there is exposed groundwater) EPS Circle One: <br />♦ - Receive one paper copy of Application form, Legal Description and Location Map <br />