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04, C <br />��. <br />COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />fk 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 866 -3567 <br />REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA <br />Please indicate if you are requesting: ❑ <br />FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA <br />ACREAGE REDUCTION (PARTIAL RELEASE) <br />If you are requesting an acreage reduction, you will need to specify how many acres you wish to remove <br />from the existing permit under this revision. I wish to release 24.00 acres at this time. <br />You will also need to submit updated mining and reclamation plan maps that accurately depict both the <br />proposed acreage to be released from the current permit area, and the resulting new permit boundary. <br />File No.: M- 2006-017 <br />Site Name: Jemadojin Sand Mine <br />County: El Paso <br />Permittee: Premier Silica LLC <br />Operator (If Other than Permittee): <br />Permittee Representative: Michael Mlclette <br />Certified Mail# gl60-3g0l-9gg;? -S"7-g go <br />In accordance with Rule 4.17.1(2) the Operator shall include the names, addresses and phone numbers <br />of all owners of record to the affected land. Please attach additional sheets for this information if <br />required. <br />Jemadojin LLC, a Colorado limited liability company, Attention Jeff and Maria Jindra, <br />16449 nearing Road, Colorado Springs, Colorado 80928 <br />RECEIVED <br />JUi 2g ?013 <br />DIVISION OF RECLAMATIAN <br />unit AND cecFF�i <br />In accordance with Rule 4.17.1(4) the Operator or their agent MUST sign that they have complied with <br />the following sta ment: "All applicable portions of the Reclamation Plan requirements have been <br />satisfied i ccord with t ese Rules and all applicable requirements under the Act." <br />7 Z �F <br />S' nature of ermittee, Operator or their authorized agent Date <br />Important: In accordance with Rule 4.17.10 This release request must be submitted to the Division <br />via certified mail and separate from any other correspondence to the Division. <br />