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STATE OF COLORADO <br />MINED LAND RECLAMATION BOARD <br />APR 1 ~ 2003 <br />PARTY STATUS WITHDRAW FORM <br />Division of fL11118rdis'~ laeolog~ <br />In the matter of F"tle No. M-~,oL.- ~~ '2 , Perx3rit/Permit <br />Name of OperatorlApplicaxitond Site: ..5E-iE~,2T G'oNS~~~~ <br />i request I be withdrawn from party status <br />___,_ I request I be withdrawp from party status and I wish to address the Board at the formal hearing, if <br />held, as a swn-party <br />(Please note that it ~, objectiag parttes wlthdraw,prior w the date set for the Board's cattsfideretIon of Ute <br />applicatitxt, the application may be approved by the Office s~ no Board hearing held. 19tus, there wilt not be <br />an opportunity tot arty person to address the Bosrd on any issues related to the application. Also, the Board is <br />not obligated to consider aay Issues raised by a party that ltas withdrawn.) <br />Regardless of a party status, the Division thoughtfully considers each issue submitte3 is wri[ing to the Division and <br />provides a response to chose issues in the Division's "Rationale for Recommendation ". Tyre "Rationale" is available to <br />any person by contacting the Division. For peasons who do not wish to become a party or withdraw as a party in this <br />matmr, please contact the Division for inforraadon tm applicarion status. <br />(Pleasa provide the Pollow''in//g information if you have or wish to have party slaws, thank you.) <br />~T n/~CE- I.. • HA.viVE.2i 7/ ~~3 - 939 <br />Printed Name klome Phone # <br />T, <br />l.~~src~.i~-Fi/ ~o Pia~s~ <br />City. State 7~p Cada <br />~/~ <br />E-I~Qail Address ~l~O <br />~z _ <br />L~ .y.9 <br />work Phone # <br />(^~ /l/A <br />FAX # <br />:4O.~.t.. /P ~ ,02003 <br />Date <br />z-d woa~ wdzv=z ~0ez-a~-v <br />