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pf C04 <br /> � 1 COLORADO DIVISION OF RECLAMATION, MINING AND SA <br /> 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 866-3567 <br /> AR-3 <br /> 8'6 LJW/TH <br /> M <br /> REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA/SURETY REDUC ivy. <br /> Please indicate if you are requesting: <br /> FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA (per Rule 4.17) ❑ R�cF� <br /> C VFD <br /> ACREAGE REDUCTION (PARTIAL RELEASE per Rule 4.17) ❑ MAR 2 <br /> 1 (n DIVI 1V 0 20?3 <br /> I wish to release acres at this time. SIO <br /> You will need to submit with this request: a map showing the acreage to be released from thAQQQ LAAAT�O <br /> permit and updated mining and reclamation plan maps that will accurately depict the new permit OSAp�TY N <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- )� �50;31 Site Name: M ikjjC(')5 1 1 <br /> County: M an�Q-Zkj-mei--Ll1XINA <br /> Permittee: M6fAe-?-1AM&, ''C <br /> Permittee Address: `�0$ DrAt 1rt S Knc�c� _ � O r�QZ <br /> Operator(If Other than Permittee): 1V 1A <br /> Perm ittee Representative: & D _ N Q ►('\- pC _4 <br /> Certified Mail# 1012 0040 0000 51W 1,310 <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. n � <br /> Continue on following page.. <br />