Laserfiche WebLink
r <br /> dperator(If Other than Permittee): same <br /> Permittee Representative: Julie Mikulas 970-407-3631 <br /> Certified Mail # 7019 1640 0000 6476 5514 <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 /> River Bluffs Ventures LLC,c/o Mike DiTuillo 1927 Wilmington Drive, Suite 101, Fort Collins, CO 80528 970-215-2464 <br /> Steamboat Partners Investments,c/o Mike DiTullio 1927 Wilmington Drive,Suite 101, Fort Collins,CO 80528 970-215-2464 <br /> East Larimer County Water District,do Mike Scheid PO Box 2044, Fort Collins, CO 80522 970-493-2044 <br /> North Weld County Water District,c/o Eric Reckentine PO Box 56, Lucerne 80646 970-356-3020 <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 /> C)w <br /> S46ature of Permittee, Operator or their authorized agent Date <br /> Important: In accordance with Rules 4.14.2(a) and 4.17.1 L) This release request must be submitted to the <br /> Division via certified mail and separate from any other correspondence to the Division. <br /> MineralsReleaselkequestform 20Sep2017 <br /> Page 2 of 2 <br />