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of Co <br /> COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> * 876 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 866-3567 <br /> REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA/SURETY REDUCTION <br /> Please indicate if you are requesting: <br /> FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA(per Rule 4.17) <br /> ACREAGE REDUCTION (PARTIAL RELEASE per Rule 4.17) ✓ AR-4 <br /> I wish to release 11.25 acres at this time. <br /> You will need to submit with this request: a map showing the acreage to be released from the current <br /> permit and updated mining and reclamation plan maps that will accurately depict the new permit <br /> boundary if the release is approved. <br /> SURETY(Bond) REDUCTION (per Rule 4.14) <br /> If you are requesting a surety (bond) reduction you will need to include with this request a new estimate <br /> of the actual cost to reclaim the site based on what it would cost an independent contractor to complete <br /> reclamation, including unit costs for reclamation activities as appropriate to the operation to comply <br /> with the provisions of Rule 3.1 and the Permit's approved Reclamation Plan. <br /> File No.: M- 1977-526 Site Name: Worthing Pit (AFS Pit #4) <br /> County: Adams <br /> Permittee: Albert Frei & Sons. Inc. <br /> Permittee Address: P.O. Box 700, Henderson, CO 80640 <br /> Operator (If Other than Permittee): <br /> Permittee Representative: Joel Bolduc <br /> Certified Mail# 7020 3160 0001 1866 1723 <br /> In accordance with Rule 4.17.1(2)the Operator shall include the names, addresses and phone numbers <br /> of all owners of record to the affected land. Please attach additional sheets for this information if <br /> required. <br /> Henderson Aggregates, LTD, P.O. Box 700, Henderson, CO 80640, 303-289-1837 <br /> Continue on following page.. <br />