Laserfiche WebLink
STATE OF COLORADO <br />MINED LAND RECLAMATION <br />PARTY STATUS WIT~IDRAW FORM <br />In the matter of File No. IvI- -_ <br />Natne of Operator/Applicant and Site: <br />Pemut/Permit Amendment Application. <br />I request I be withdrawn from party status <br />_ I request I be withdrawn from party status and I wish to address the Boazd at the formal hearing, if <br />held, as anon-party <br />(Please note that if all objecting parties withdraw rior to the date set for the Board's consideration of the <br />application, the application may be approved by the Office and no Board hearing held. Thus, there will not be <br />an opportunity for any person to address the Board on any issues related to the application. Also, the Board is <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not obligated to consider any issues raised by a party that has withdrawn.)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 those 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 following information if you have or wish to have party status, thank you.) <br />Address Work Phone # <br />(~ <br />City, State Zip Code FAX # <br />E-IvIail Address Date <br />Signature <br />