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Operator(If Other than Permittee): High Mesa Gravel, LLC <br /> Permittee Representative: George P. BOuraSSa <br /> Certified Mail # .1��� ILA0 qqz>' ct�S6 .-1G�� <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 /> George P Bou rassa 805 North Crest Dr,Suite 101,Grand Junction,CO 81506 (970) 201-6433 <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 folloNving 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 /> 11/24/2020 <br /> Si n re of Permitt Operator or their authorized a ent Date <br /> Important: In accof danc wit Rules 4.14.2(a) and 4.17.10) This release request must be submitted to the <br /> ivision via certified mail and separate om any other correspondence to the Division. <br /> JLneralsRe ,eReque ffo"2USep' <br /> Page 2 of 2 <br />