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Operator(If Other than Permittee): <br /> Permittee Representative: ,John Henderson, Attorney at Law <br /> Certified Mail# <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 /> Fontanari Family 3316 E 3/4 Road 970 434 7948 <br /> Revocable Trust, Clifton, CO 81520 <br /> Rudolph Fontanari, <br /> Trustee <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 /> -- <br /> Signature&Permittee,Operator or their uthorized agent Date/f...4p <br /> Important. In accordance with Rules 4.14.2(a)and 4.17.1 Q) This release request must be submitted to the <br /> Division via certi,�ted mail and separate front any other correspondence to the Division. <br /> hI...Wtek=It ram 2GSq%WI7 <br />