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\\► � OF COO <br /> n O <br /> COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> �Y y� 1313 Sherman Street, Room 215,Denver Colorado 80203 ph(303)866-3567 <br /> */s 76 <br /> REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA <br /> Please indicate if you are requesting: <br /> FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA <br /> ACREAGE REDUCTION (PARTIAL RELEASE) F] <br /> If you are requesting an acreage reduction, you will need to specify how many acres you wish to remove <br /> from the existing permit under this revision. I wish to release 16.36 acres at this time. <br /> You will also need to submit updated mining and reclamation plan maps that accurately depict both the <br /> proposed acreage to be released from the current permit area, and the resulting new permit boundary. <br /> File No.: M- 1978-210 Site Name- Geisert pit(Celt B) --1�--`� <br /> A- <br /> County: Weld <br /> tCLJ!' <br /> Weld County ✓ <br /> Permittee: ri No Violations <br /> Operator (If Other than Permittee): Feld county public works <br /> Permittee Representative: Clay Kimmi <br /> Certified Mail# -701 u v 150 cx> 716b al(f <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 /> WELD COUNTY, 1150 O ST.,GREELEY,CO 80631-9596 <br /> In accordance with Rule 4.17.1(4)the Operator or their agent MUST sign that they have complied with <br /> the following statement: "All applicable portions of the Reclamation Plan requirements have been <br /> satisfied in accordance with these Rules and all applicable requirements under the Act." <br /> 11/30/16 <br /> Signa re of Permittee, Operator or their authorized agent Date <br /> Important: In accordance with Rule 4.17.10)This release renuest must be submitted to the Division <br /> via certified mail and separate from any other correspondence to the Division. <br />