Laserfiche WebLink
~ III IIIIIIIIIIIIIIII ~ ~ <br />STATE OF COLv:2AD0 <br />MINED LAND RECLAMATION BOARD <br />RECEIVED <br />MAR 12 2001 <br />Division of Minerals and Geology <br />PARTY STATUS FORM <br />In the mater of File No. M-a~0 _~ <br />Name of Operator/Applican[ and Site: <br />nit/Permit Amendment Application. <br />vt cl. ~e- Gra ~ ~ ( LL C. <br />I request that I be named as a parry <br />I request that I not be named as a party <br />I understand that I have party status <br />I request I be withdrawn from party sta[us <br />I wish to address the Board at the Formal <br />heazing, if held, as a non-party <br />(Please note that if all objecting parties withdraw np 'or to the date se[ for the Division's recommendation for <br />approval or denial, there may not be an opportunity for any person to address the Board on any issues related <br />to the application. If all objecting parties withdraw their objection after the above referenced date, the Board <br />may still hold a formal hearing, however the Board is not obligated to consider any issues raised by a party that <br />has withdrawn.) <br />Regardless of a party s[atus, the Division thoughtfully considers each issue submitted in writing to the Division and <br />provides a response to those issues in the Division's "Rationale For Recommendation ". The "Rationale" is available to <br />any person by contacting [he Division. For persons who do not wish to become a party or withdraw as a party in this <br />matter, please contact the Division for information on application status. <br />(Please provide the Following information if you have or wish [o have parry status, thank you.) <br />Prin//red GGName I / <br />Address <br />City, State ~ Zip Code <br />~gr-I-~t~b~ock n~.ICCet~ONer4y• COrvI. <br />E-Mail Ad re~- <br />Signature <br />Home Phone ~ <br />( 03>~aC~-f313 <br />Work Phone # <br />FAX ;# <br />a rc.~, a O O ( <br />Date <br />If you are not now a party and you wish to be named as a party, please provide the following: <br />• How you may be affected or aggrieved by the Board's decision if the Board decides to approve the application. <br />(Please at[ach additional pages if needed) <br />Please explain your opposition to the matter, including a specific description of the issues that you feel need to be <br />addressed at [he Formal Board Hearing and why. <br />(Please a«ach additional pages if needed) <br />