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<br /> <br />• • T OF COL ~ •• RECEI4lED <br />S ATE ORA O <br />MINED LAND RECLAMATION $OARD JUN 2 5 T001 <br />PARTY STATUS FORb1 Division of Minerals and Geology <br />Ir. the matter of File No. 141- ODO_ , petmid'2ermit rlmendtncn[ Ag lication. <br />Narne of Operator/Applicazit and Site: SR s L L C S <br />N aI O L d <br />_ I request that I be named as a party ~ I request I be w[thdrawn :rom party status <br />,~ I request thzt I not be named as a party <br />f f wish to address the Boazd at the forma] <br />hearing, i` held, as a non-patty <br />I understand thaz I have party status <br />(Please note that if ail objecting parties withdraw rio or to the date set Por the Division's reeommendation for <br />approval or denim, there may not be an oppornrnity for any person to address the Board on any issues related <br />to the application. If ~D objecting parties withdraw their objection after the above referenced date, the Board <br />may still hold a formal hearing, however the Board is not obligated W consider any issues raised by a party that <br />bas withdrawn.) <br />Regardless of a party status, the Division dtougittittily considers each issue submitted in writing w the Division and <br />provides a response [o those issues in the Division's "Rationale Far Recor:tmendation ", The "Rationale" is available W <br />any person by contacting the Division. For persons who do not wish to become a patty or withdraw as a parry in this <br />matter, please conract the Division for infortation ott applicaticn status. <br />(Please pwwrovide the follovi/nyg~information it you have or wise to have party stetus, thank you.) <br />17U rTi nl I t 1. ~Mr~.~./~ •~i]~ _ L~) <br />Printed N.nme ',,,~ f ~~fpV rC Pl ~rrC , Home Phone N <br />c3°3 ~ ~`1~- 7y8'~ <br />Address Vdork Phone ~ <br />Ctty, State <br />Zip Code <br />(~~) <br />FAX M <br />E-Mail Address <br />~~~~, <br />Signntta•e , <br />Date <br />IF you are not now a pzL-ty sad yo:t wish to'~e named as 3 parry, please provide the following; <br />• How you may be affected or a~'rieved by the Soard's dectsion if [he $oard decides to approve the application. <br />(P;ease attacE ad0ition:] pages if needed) <br />Pleue explain yot:r opposition to the rnarrer, including a specific desc-ipticn of the issues that you feel need to be <br />addr:sled at the Forma! Board Hearing and why. <br />iPlaase awch addidonai pages :: needed) <br />