2013-05-06_REVISION - M2004009 (4)

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of cow p * , COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY *,* 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 866 -3567 1876 REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA Please indicate if you are requesting: FULL /FINAL RELEASE OF ENTIRE PERMITTED AREA El ACREAGE REDUCTION (PARTIAL RELEASE) If you are requesting an acreage reduction, you will need to specify how many acres you wish to remove from the existing permit under this revision. I wish to release acres at this time. You will also need to submit updated mining and reclamation plan maps that accurately depict both the proposed acreage to be released from the current permit area, and the resulting new permit boundary. File No.: M- 2004 -009 site Name :Turnpike Mining Resource County: WZY6 Permittee :Asphalt Specialties Co., Inc. Operator (If Other than Permittee): Permittee Representative: Rob Laird, Resource Manager Certified Mail# 7011 &3500 OCO.Z 96n 76-I-1 In accordance with Rule 4.17.1(2) the Operator shall include the names, addresses and phone numbers of all owners of record to the affected land. Please attach additional sheets for this information if required. 1.) Town of Erie, P.O. Box 750, Erie, Co 80516 (Attn: Gary Behlen, Public Works ni rer4n r) 2.) Spallone & Schafer Ventures, LLC, 4 Garden Center, Suite 200, Broomfield, CO 80020 In accordance with Rule 4.17.1(4) the Operator or their agent MUST sign that they have complied with the following statement: "All applicable portions of the Reclamation Plan requirements have been satisfied in accordance with these Rules and all applicable requirements under the Act." Signature of Permittee, Operator or their authorized agent Date Important: In accordance with Rule 4.17.10 This release request must be submitted to the Division via certified mail and separate from any other correspondence to the Division.