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* *. COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> ,T <br /> 1876 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 866-3567 <br /> . , <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) ❑ Q01 <br /> ACREAGE REDUCTION (PARTIAL RELEASE per Rule 4.17) �/�IIOL <br /> I wish to release .93 acres at this time. ATjpNS <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. RECEIVED <br /> SURETY (Bond) REDUCTION (per Rule 4.14) ❑ MAY 0 2 016 <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 contractOMM 1 UMWTION <br /> reclamation, including unit costs for reclamation activities as appropriate to the operation toWPo sFETY <br /> with the provisions of Rule 3.1 and the Permit's approved Reclamation Plan. <br /> File No . - / / /` Site Name: g-jj �f� f int <br /> County: }- a k7 ` <br /> Permittee:_ <br /> Permittee Address: / � �f Ov s " _ /Tslt'�I Gt-1-� Ca <br /> ���� �j�C•l�y v o? /VI D 1�'c��n L'�v n f� (�fl 70/ � A �-� <br /> �. <br /> Operator(If Other than Permittee): <br /> Permittee Representative: TA. l--k7 E S �? <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.. <br />