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AVCOLORADO <br /> Division of Reclamation, RECEIVED <br /> Mining and Safety <br /> JUL 18 2022 <br /> 1313 Sherman.Street, Roorn 215 <br /> Denver. CO 80203 DIVISION OF RFr!AMATION <br /> MINING AND SAFETY <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) <br /> I wish to release 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 boundary <br /> 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 of <br /> 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 with <br /> the provisions of Rule 3.1 and the Permit's approved Reclamation Plan. <br /> File No.: M--2vtc3—c,55 Site Name: <br /> Cl A Q-e <br /> County: <br /> Permittee: <br /> Permittee Address: <br /> ,._ 2-4 <br /> (tree Address) <br /> C c sc& <br /> (City) (State) (Zip) <br /> 1313 Sherman Street, Room 215, Denver, CO 80203 P 303.866.3567 F 303.832.8106 http://mimng.state.co.us t t <br /> John W. Hickentooper, Governor I Robert W. Randall, Executive Director I Virginia Brannon, Director ` <br />