My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2019-04-24_REVISION - M1983130
DRMS
>
Day Forward
>
Revision
>
Minerals
>
M1983130
>
2019-04-24_REVISION - M1983130
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
12/18/2024 6:28:01 AM
Creation date
4/24/2019 4:15:49 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1983130
IBM Index Class Name
REVISION
Doc Date
4/24/2019
Doc Name
Request For Surety Release
From
Elbert County Road & Bridge
To
DRMS
Type & Sequence
SL1
Email Name
JPL
MAC
Media Type
D
Archive
No
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
3
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Operator(If Other than Permittee): <br /> Permittee Representative: <br /> Certified Mail# ►` 1 <br /> In accordance with Rule 4.17.1(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 /> 'Bc b `T ll o-Aon 34 q 6 cog, 137 7ZJ-.sVl -,211; 7 <br /> 0 <br /> In accordance with Rule 4.17.1(4),if requesting a partial acreage release the Operator or their agent MUST sign that <br /> they have complied with the following statement: "All applicable portions of the Reclamation Plan requirements <br /> have been satisfied in accordance with these Rules and all applicable requirements under the Act." <br /> Signature ermittee,Werator or their authorized agent Date <br /> Important: In accordance with Rules 4.14.2(a) and 4.17.10) This release request must be submitted to the <br /> Division via certified mail and separate from any other correspondence to the Division. <br /> Min—IsRelemeRequestForm 20Sep2017 <br /> Page 2 of 2 <br />
The URL can be used to link to this page
Your browser does not support the video tag.