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MAC WHE <br /> M-1977-534 AR01 <br /> J Annual Fee/Report: CW OF RECLAMATION, MINING AND SAFETY <br /> No Violations )orn 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: RECEPIED <br /> FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA (per Rule 4.17) <br /> n OCT U v 21011 <br /> ACREAGE REDUCTION (PARTIAL RELEASE per Rule 4.17) L� DMSION OF _ <br /> 130.08 MINING AND SAFETY <br /> �N <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. <br /> File No.: M- 1977-534 site Name: Empire Pit <br /> county: Clear Creek <br /> Permittee: City of Golden <br /> Permittee Address: 911 10th Street <br /> Golden CO 80401 <br /> Operator (If Other than Permittee): <br /> Permittee Representative:Anne Beierle 303-384-8153 <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. Glenda Guanella P. O. Box 128 Empire CO 80438 303-569-2839 <br /> Sally Buckland P. O. Box 56 Empire CO 80401 303-569-2988 <br /> Continue on following page.. <br />