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07/07/2008 MQN 16:45 FAX 720 977 6202 City of Thornton <br />STATE OF COLORADO <br />MINED LAND RECLAMATION BOARD <br />PARTY STATUS WITHDRAWAL FORM <br />In the matter of File No, M-.2oo-4- - C> F5_7 - -_-, Permit/Permit Amendment Application. <br />0002/002 <br />N?= of Operator/Applicant and Site: ?Le..r? a ylc( ?c7,r?_CTj to c? , <br />f` L b (11? r "r <br />? I hereby withdraw as a party to this matter. <br />I hereby withdraw as a party to this matter and, if the Board holds a hearing, I <br />wish to address the Board at the formal hearing, if held, as it non-party. <br />(Please note that if all objecting parties withdraw prior to the date set for the Board's <br />consideration of the application, the application may be approved by the Office without the <br />Board holding a hearing. In that event, there will be no opportunity to address the Board on any <br />issues related to the application. Also, the Board is not obligated to consider any issues raised by <br />a person or an entity that has withdrawn as a party.) <br />Regardless of a party status, the Division thoughtfully considers each issue submitted in writing <br />to the Division and provides a response to those issues within its jurisdiction in the Division's <br />"Rationale for Recommendation." The Rationale is available to any person by contacting the <br />Division. For persons who do not wish to become a party or withdraw as a party in this matter, <br />please contact the Division for information on applica t-on status. <br />Printed Name 0A0-1'14Ljf1 Home Phone # <br />A ess T Work Phone # <br />City, State Zip Code FAX # <br />a? s Dates <br />Signatu <br />12