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$ COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />187 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 861'x3567 <br />"" <br />REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA/SURETY RB ION <br />Please indicate if you are requesting: I q'101 <br />FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA (per Rule 4.17) `� <br />Hoy �G,�' <br />ACREAGE REDUCTION (PARTIAL RELEASE per Rule 4.17) ❑ �_ �5� <br />60 <br />I wish to release 7.acres at this time. <br />You will need to submit with this request: a map showing t'- - - A V -^T A.- ^•..o... <br />permit and updated mining and reclamation plan maps that <br />boundary if the release is approved. S LQ <br />SURETY (Bond) REDUCTION (per Rule 4.14) ❑ Co dl <br />If you are requesting a surety (bond) reduction you will ne Violations <br />of the actual cost to reclaim the site based on what it would cost TC <br />contracEur Lu wmptrnu <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 -163 -SG <br />Site Name: Fisher Pit <br />County: Lincoln <br />Permittee: Lincoln County <br />Permittee Address: P.O. Box 39 <br />Hugo, CO 80821 <br />Operator (If Other than Permittee): <br />Permittee Representative: Trey James <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. Shriner's Hospital for Children <br />ATTN: Tom Guthrie <br />P.O. Box 31356 <br />Tampa, FL 33631-3356 <br />Phone; (813) 281-0300 <br />Continue on following page.. <br />