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Operator(If Other than Permittee): <br /> Permittee Representative: Michael Volosin <br /> Certified Mail# .7 0 l.- / 7 as GQ .71,5r7 YYF( <br /> In accordance with Rule�(2)the Operator shall include the names, addresses and phone numbers of all <br /> owners of record to the affected land. Please attach additional sheets for this information if required. <br /> Name Address Phone Number <br /> FRONT RANGE FEEDLOTS LLC PO BOX 517 EATON CO 80615-0517 970-454-3181 <br /> 7 <br /> Ina ordance with Rule 4.1 .1(4), if requeWng a partial acreage release the Operator or their agent MUST sign that <br /> t y have complied with e following st ement: "All applicable portions of the Reclamation Plan requirements <br /> ave been satisfied in a ordance wit ese Rules and all applicable requirements under the Act." <br /> //0 <br /> ure of e itt , Operator or their authorized agent Dfite <br /> Im ortant: In accordance with Rules 4.14.2 a and 4.17.1 3 This release request must be submitted to the <br /> Division 4a certified mail and sg arate from anv other corresi2ondence to the Division. <br /> MmeralsReleaseRequesfform Mep2017 <br /> Page 2 of 2 <br />