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STATE OF COLORADO <br />MINED LAND RECLAMATION BOARD <br />PARTY STATUS WITHDRAWAL FORM <br />In the matter of File No. M- 1973 - 021 , Permit or Amendment Application. <br />Name of Operator/Applicant: Aggregate Industries <br />Site Name: Morrison Quarry (AM7) <br />X I hereby withdraw as a party to this matter. <br />I hereby withdraw as a party to this matter and, if the Board holds a hearing, I <br />wish to address the Board at the formal hearing, if held, as a non-party. <br />(Please note that if all objecting parties withdraw prior to the date set for the Board's <br />consideration of the application, the application may be approved by the Office without the <br />Board holding a hearing. In that event, there will be no opportunity to address the Board on any <br />issues related to the application. Also, the Board is not obligated to consider any issues raised by <br />a person or an entity that has withdrawn as a party.) <br />Regardless of a party status, the Division thoughtfully considers each issue submitted in writing <br />to the Division and provides a response to those issues within its jurisdiction in the Division's <br />"Rationale for Recommendation." The Rationale is available to any person by contacting the <br />Division. For persons who do not wish to become a party or who withdraw as a party in this <br />matter, please contact the Division for information on application status. <br />r5 WA O�- r r► �n <br />rinted Name <br />Address <br />�0rr- <br />City, State Zip Code <br />( 1 <br />Home Phone # <br />Work Phone # <br />Jai <br />FAX # <br />E- ail Address Date <br />Signature <br />