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STATE OF COLORADO <br />MINED LAND RECLAMATION BOARD <br />ARTY STATUS WITHDRAW FO:RM? <br />In rho mama of File xo, Fermit/Mrmit Amendm"t ,application. <br />Name of Operator/Applicant and Site <br />I "nest 1 be withdrawn from party state <br />I request I be withdrawn from party status and I wish to addmss the. Board at the formal hearing, U <br />held, as a non-party <br />('leases :note that if-4 objecting partite avithdraw Elio o the vote net for tlt )Hoard's consideradon of the <br />aRFh+'adm the application may be approved by the Office and no Beam hearing hd& Tbus, there wtil not be <br />an trppartu" for any person to address the Bo*W on any hwa rotated to the application. Ado, the Board 1s <br />not olelilgated to consider any Wm ralmd by a party that has widufrawn.) <br />Regardless of a party stares, the Divisions thoughtful:ty owniders each issue submitted in writing to the Division and <br />ptvvides a response to those imes in the DivisioWs "Rationale for Reconvnendation °. The " Rationsalle" is available to <br />any person by contacting the Division. For pets= who do am w+isls to become a party or withdraw as a party in this <br />matter, pkase contact titre Division for infon=ion on application staws- <br />(NZRW & b%@ fv'iao g ink e» if YOU haul 4t Wish to havc party stators, t k yfle_) <br />Printed Name <br />3 <br />Addmu Work Pherae _ <br />city, .state Zip +C 1'Ax # - - <br />I L4 -.y { 1 1 <br />Date <br />k '. <br />RECEIVED <br />SEP 0 0 2008 <br />-? Division of Reclamation, Mining and Safety <br />II <br />II IIIAIIIIUI?IAIIAII?I??II??? <br />...N uH .wt;'6}' x YN "F.C'1"' n?Y ::a-, 4 - , ? ?, '-?. "',+? r?..,,?? fi , <br />*kL S Zf'n3_:sf M 1` a`$ .ti T , _ + _ r•v., .iis,??t r.