Laserfiche WebLink
STATE OF COLORADO <br />MINED LAND RECLAMATION BOARD <br />PARTY STATUS ~`i'ITHDRA~'V FORM <br />In the matter of ?=ile 1Vo. ~!- <br />Name of Operator/Applica t and Site: <br />e-nl`u~er^:it A_nencment App'•cation. <br />I request I be withdrawn from party status <br />I request I be v?~it?~drawn from patty status and I tvish to address the•Board at *he formal hearing, if <br />held, as a Wort-parry <br />(Please note that if aii objecting parties tk'ithdraw rerior to tl:c date set .,r the Board's consideration os'the <br />application, the application may be approved by the Office and no Board hearing held. Thus, there wilt not tae <br />an opportunity for any person to address the Board on any issues related to the application. Also, the Board as <br />not obligated to consider any issues raised by a party that has withdrawn.) <br />Regardless of a party status, the Division thoughtfully considers each issue submitted in writing to the Division and <br />provides a response to these issues in the Division's "Rationale for Recommendation ". The "Rationale" is available to <br />any person by contacting the Division. For persons who do not wish to become a party or withdraw as a party in this <br />matter, please contact the Division for information on application status. <br />(Please provide the fol]owing information if you have or wish to have party status, thank you.) <br />Printed Name Home Phone # <br />) <br />( <br /> <br />Address -- <br />- <br />Work Phone # <br />()- <br />City, State Zip Code FAX # <br />E-Mail Address Date <br />Signature <br />