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r„,'N <br /> , ,�t . COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> 1313 Sherman Street, Room 215, Denver, Colorado 80203 x(303)866-3567 <br /> REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA/SURETY REDUCTION <br /> RECEIVED <br /> Please indicate if you are requesting: <br /> FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA(per Rule 4.17) ❑ JUN 01 2016 <br /> ACREAGE REDUCTION (PARTIAL RELEASE per Rule 4.17) XI DIVISION OF RECLAMATION <br /> .� — �� f MININGANDSAFETY <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.Q <br /> 1/ File No.: M- I 1 86 -- 6 Site Name: L4 L LL '3/267/X02s 3 <br /> County: C7gi2 0 <br /> V Permittee: ( 4 L 1)k i L L /.>RO 71 f ,rc S J Annual Fee/Report CW <br /> C, d No Violations <br /> .� <br /> Permittee Address: S �� I� 9 <br /> r- <br /> ��tC(CK f-c ? L ('C) (CSC. f <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 /> () juNitS 4f. ( A-L-Du. ELL <br /> 5 C..) R () <br /> R o cv ft,), (L` rS/1 Pit ,u 7/1-_ /tcS� ._a;c/6 <br /> L W c-1 AJC C4 L dCt) <br /> 1). of7 30( 701 <br /> c / tCiuto ' L LLS , Co dog /0 <br /> Continue on following page.. <br />