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44.,.:>) COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> 1313 Sherman Street, Room 215, Denver, Colorado 80203 ph(303) 866-3567 <br /> REQUEST FOR FULL OR PARTIAL RELEASE OF PERMIT AREA/SURETY REDUCTION <br /> Please indicate if you are requesting: RECEIVED <br /> FULL/FINAL RELEASE OF ENTIRE PERMITTED AREA (per Rule 4.17) ❑ RECEIVED <br /> IY <br /> ACREAGE REDUCTION (PARTIAL RELEASE per Rule 4.17) ...Kr JAN 1 5 2016 <br /> 11r �� DIVISION Oft RECTIONI I wish to release acres at this time. MINING AND SAFETY <br /> You will need to submit with this request: a map showing the acreage to be released from the current <br /> permit and updated mining and reclamation plan maps that will accurately depict the new permit <br /> boundary if the release is approved. ARO 1 <br /> SURETY (Bond) REDUCTION(per Rule 4.14) n ✓Complied(Due 1/16/16)! <br /> If you are requesting a surety(bond)reduction you will need <br /> of the actual cost to reclaim the site based on what it would c ✓O Violations <br /> reclamation, including unit costs for reclamation activities as <br /> with the provisions of Rule 3.1 and the Permit's approved Reclamation Plan. <br /> File No.: M- (2-0(.2 i ' 022 Site Name: a reer il'Ot U 5x,r61 (walle' M e) <br /> County: Wild <br /> Permittee: LC)V€W RQLd9 V) C1.IV/UL, 111.G. <br /> Permittee Address: PO ISO'(, /69 LUVtUt4 eo 6b <br /> Operator(If Other than Permittee): <br /> Permittee Representative: halni,e 1(.he r <br /> ZLInCertified Mail# 1 10 0- 1010 0000 1 Si 2 c124- <br /> In <br /> 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 /> l oU� R e 'ravy, Cola&, n <br /> Leon 4-}, Groin .vL"1" .mill -Th t - Viola G. Crbhsa.+nf Tirusi-eo {�Z �-- <br /> Vtckot 0 CAT'1 ,tet I 2- "Loh <br /> Continue on following page.. <br />