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*e COLORADO DI VI SI ON OF RECLAM ATI ON, M 1 NI NG AND SAFETY <br /> * *1876 an 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: n <br /> FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA(per Rule 4.17) L� <br /> ACREAGE REDUCTION(PARTIAL RELEASE per Rule 4.17) LJ <br /> LJW/THM <br /> I wish to release 9.80 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- M-1999-073 Site Name: Pit 1 <br /> County:Costilla <br /> Permittee: Evan L. Melby <br /> Permittee Address: P.O. Box 4159 R C E I V E n <br /> Ventura, CA 93007 JAN 2 3 2023 <br /> DIV}SION OF RECLAMATION, <br /> Operator(If Other than Permittee): MiNING 8.SAFETY-MINERALS <br /> Permittee Representative: Darlene Melby <br /> Certified Mail# ANC Z- C l I 1 68c,t /-';14 C <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. Evan L. Melby Inc. <br /> P. O Box 4159, Ventura CA 93007 <br /> P. O Box 4159, Ventura CA 93007 <br /> P. O Box 4159, Ventura CA 93007 <br /> P. O Box 4159, Ventura CA 93007 <br /> P. O Box 4159, Ventura CA 93007 <br /> Continue on following page.. <br />