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DECEIVED <br />APR 0 7 2009 <br />STATE OF COLORADO Division ur KedA"Wo , <br />MINED LAND RECLAMATION BOARD Mining and Sd* <br />PARTY STATUS WITHDRAWAL FORM <br />In the matter of File No. M- ?2-&0 e - 0 7 X , Permit/Permit Amendment Application. <br />Name of Operator/Applicant and Site: -.R f G,4 C_ <br />GU 11 i f I;lr d. A-i-AX, 4 <br />x 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 a 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a person or an entity that has withdrawn as a party.)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 application status. <br />1A,viv,,?- 0Avio /?.tii (Ping! Vti fix f 5 l '^ (11# ) S3 6-3 J :Z ? <br />Printed Name Home Phone # <br />°I1-1;,r& 4 4&t !k;k - 55- 71 17 ) (0 ?sss' - L/Zfsv5_ <br />Address Phone # <br />G-irm y G, x I a 6-? - 2x-?,- <br />City, State Zip Code <br />E-Mail Address <br />Si ture <br />FAX # <br />-'26 9 <br />Date <br />12