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WW GRM <br /> M-2001-001 AR02 ION OF RECLAMATION, MINING AND SAFETY <br /> J Annual Fee/Report: C'+W met Room 215, Denver, Colorado 80203 ph(303) 866-3567 <br /> J No Violations <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 /> Y G <br /> ACREAGE REDUCTION(PARTIAL RELEASE per Rule 4.17)_ OCT 16 2017 <br /> DIVISION OF RECLAMAT101 <br /> I wish to releasena 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. <br /> SURETY(Bond) REDUCTION (per Rule 4.14)_ <br /> If you are requesting a surety (bond) reduction you will need to include with this request 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, including unit costs for reclamation activities as appropriate to the operation to comply <br /> with the provisions of Rule 3.1 and the Permit's approved Reclamation Plan. <br /> File No.: M- Q CkA —w\ Site Name: <br /> County: ox <br /> Permittee: L--�--C-- <br /> Permittee Address: f,—v c� <br /> Operator(If Other than Permittee): <br /> Permittee Representative: <br /> Certified Mail# <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 /> Q1�- <br /> Continue on following page.. <br />