Laserfiche WebLink
STATE OF COLORADO • <br />MI I'sD LAND RECLAMATION BOARD <br />PARTY STATUS REQUEST FORM <br />/ I request that 1 be named as a party <br />!~ I request that I not be named as a party <br />,~ DECEIVED <br />I request to be withdrawn from party status <br />MAY 21 1999 <br />Itt the matter of File No. M-~Z-~L: <br />of Minerah 8 Geology <br />For people who do not wish to become parties in this matter, information on the permit <br />application process can be requested from the Division of Minerals and Geology. <br />~~~ G~f ~ ~ , ~<- ~ 6 ~ <br />Printed Name <br />Addres <br />y <br />City, S to 'p Code <br />r ~ _ <br />Home Phone # <br />( ) - - <br />Work Phone # <br />FAX # <br />E-Mail Address <br />i <br />~C .~ <br />Si nature <br />~ ~~~ t~ 9 <br />Date <br />It you are requesting to be named as a party, please briefly describe below how you may be <br />affected or aggrieved by agency action in the matter referenced above. Include a statement of <br />your opposition or support in the matter. You may attach a written statement to thls form instead <br />of filling in the space below.:include a specific description of the issues that you feel need to be <br />addressed at the final hearing before the Mined Land Reclamation Board. <br /> <br />