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of Co <br />N`ti Ipy <br />$ COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1876 *"7» 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 866-3567 <br />REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREAISURETY REDUCTION <br />Please indicate if you are requesting: �ECi��V��, <br />FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA (per Rule 4.17) _� <br />ACREAGE REDUCTION (PARTIAL RELEASE per Rule 4.17) _ D JUN 2 -0 2017 <br />I wish to release acres at this time, DIVISION OF RECLAMATION <br />You will need to submit with this request: a ma showing the acreage to be released fr m IyG current <br />q P g g ING current - <br />permit and updated mining and reclamation plan maps thS ' <br />boundary if the release is approved, --W-2009-054P <br />ffU11 ✓ Complied! <br />SURETY (Bond) REDUCTION (per Rule 4.14) L]! ✓0 Violations: <br />If you are requesting a surety (bond) reduction you will nAU <br />E <br />of the actual cost to reclaim the site based on what it wou WI -JE, <br />reclamation, including unit costs for reclamation activities as appropriate to the operation to comply <br />with the provisions of Rule 3.I and the Permit's approved Reclamation Plan. <br />File No.: M- SAN # DSL4 Site Name:P-ache P1. <br />County:_ <br />Pennittee <br />Permittee <br />Operator (If Other than Permittee): <br />Permittee Representative: <br />Certified Mail# 7 +j c.3 o CM1 tp'7Ob 419 L5 <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 />