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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 866-3567 <br />REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA/SURETY REDUCTION <br />Please indicate if you are requesting: <br />FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA (per Rule 4.17) _______ <br />ACREAGE REDUCTION (PARTIAL RELEASE per Rule 4.17) _________ <br />I wish to release acres at this time. <br />You will need to submit with this request: a map showing the acreage to be released from the current <br />permit and updated mining and reclamation plan maps that will accurately depict the new permit <br />boundary if the release is approved. <br />SURETY (Bond) REDUCTION (per Rule 4.14) _________ <br />If you are requesting a surety (bond) reduction you will need to include with this request a new estimate <br />of the actual cost to reclaim the site based on what it would cost an independent contractor to complete <br />reclamation, including unit costs for reclamation activities as appropriate to the operation to comply <br />with the provisions of Rule 3.1 and the Permit’s approved Reclamation Plan. <br />File No.: M- Site Name: <br />County: <br />Permittee: <br />Permittee Address: <br />Operator (If Other than Permittee): <br />Permittee Representative: <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 />Continue on following page..