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COLORADO DIVISION OF RECLAM ATl ON, MINING AND SAFETY <br />** � 1313 Sherman Street, Room 215, Denver, Colorado 802M pNW3) 86C WU <br />1876 <br />s rt <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) <br />ACREAGE REDUCTION (PARTIAL RELEASE per Rule 4.17) NOV 2 9 2016 <br />DMSM OF RECL MATXM <br />I wish to release acres at this time. M1WG <br />You will need to submit with this request: a map showing the acreage to be released from the cuivol <br />permit and updated mining and reclamation plan maps that will &NEdcamtel . pict the new permit �-W <br />boundary if the release is approved. <br />ilw rr� ,��,`, <br />nn <br />U_ <br />SURETY (Bond) REDUCTION (per Rule 4.14) _ 1, <br />If you are requesting a surety (bond) reduction you will need to include with this reques a new estimate <br />of the actual cost to reclaim the site based on what it would cost an independent contractor to complete <br />reclamation, i MIts <br />for reclamation activities as appropriate to the operation to comply <br />with the isions of Rulethe Permit's approved Reclamation Plan. <br />File No.: <br />County: <br />C� Site Name: %-exve'-z <br />a v i"7' <br />Permittee: ,�/PC �� ,?,QS,7,-^J 4:� <br />Permittee Address: Pej - eaX fes` Gd <br />e-6 e.7el /P/1 d S De ,j <br />Operator (If Other than Permittee): <br />Permittee Representative: 0( � k C), M YO <br />Certified Mail#.1Bev,- -A i ihk <A <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 />P U enX -Z,? Z <br />Gt, k,463 i <br />Volvp . 77r 7e- 'Y37 Z <br />Continue on following page.. <br />