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`e 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: RECEIVED <br /> FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA(per Rule 4.17) ❑ <br /> p�ACREAGE REDUCTION(PARTIAL RELEASE per Rule 4.17) �1�1AR 092016 <br /> DIVISION OF RECLAMATION <br /> I wish to release acres at this time. MININGANDSAFErY <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- � � 1 -ZZ Site Name: VALL& V1 S ( ' <br /> County: At,,' <br /> Permittee: PA1Z,iz1,c/Z S oti i ULW$1-"Cn u N <br /> Permittee Address: -7 1 0 56V-114 I S1`iz416-r- <br /> c�;�s n J✓J�C��� Gt� � �S� � <br /> Operator(If Other than Permittee): L <br /> Permittee Representative: ILA±� <br /> Certified Mail# ggbl I I W CUBE 3478 a6g7 q,) <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 /> 7/0 So vi 1•f i�� <br /> v AF & Report Continue on following page.. <br /> J No Violations <br />