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,. - - - .- - <br />`O<~ I <br />~~ 7~ y0 <br />~o D[PARTMENT OF NATURAL RESOURCES <br />r J a Tai ~ David N Gelchea. Esecullve Dlreclor <br />' '~'~' MINED LAND RECLAMATION DI1 <br />B 76 ~ DAVIb C. SNElTO N, Dlre clot <br />Nchard D Lamm <br />cOVe1"°` APPLICATION FORM FOR A REYISION <br />TO A COAL MINING AND RECLAFIATION PER!•1[T <br />This form must be completed and submitted with all requests for minor revisions, as <br />defined in Rule 1,04173), technical revisions as defined in Rule 1.04(36) and permit <br />revisions, as defined in Rule 1.04(90). All revisions are to address Lire requirements <br />of Rule 2.08.4.. <br />All revisions are to be formatted so they can be Inserted into the permit to replace the <br />revised sections, maps, tables and/or figures. Explain In the revision what section is <br />being revised. The revision date should be printed in the lower right corner of the <br />revision pages. if necessary, the Table of Contents should also be revised. <br />Oate: O Z/ 0 2/ 8 7 <br />Permittee: p E A B O D Y C O A L G 0. <br />--------------- <br />--------------- <br />Street: L ~. 2 0- S 0 U T H_ Y A L E <br />--------------- <br />r,l F A A G T A F F __ ________ <br />_ _ S <br />S A~ Zlp Code: 8 6 0 0 1-_ __ <br />Permit No.: C- 8 0- 0 0 5 <br />This box to be filled in by the Division: <br />Type of Revision: _ _ (PR, TR, or F1R) <br />Revision slumber _ _ (Sequential by P.evision Type) <br />Revision Submittal Date _/_/_ (Date Received by Division) <br />Revision Completeness Date -/_/^ Revision incompleteness Date _/_/ <br />Revision Adequacy Oue Oate _/_/_ Revision Adequacy Date _/_/_ <br />Revision C~cislon Due Date / / fee E0.00 <br />Arse/ Description of Revision: T E <br />-- M P O <br />--- R A <br />-- R Y <br />--- M I N E <br />----- <br /> S E Q U E N C E_ C H A N G E __ <br />Public Notice Attached - Yes _ No X (P,equ(r ed for PR's and TR's) <br />Bond Increase: Yes _ Ho X <br />Proposed Change in: <br />ni rbed Area (~/-} _ _ 0 .Q Acres Affected Area (~/-} _ _ 0 .0 hcres <br />Pet Area ({/-1 ~ _ ~.~ Acres Federal Land (+/-) _ _ 0 Acres <br />State Land (+/-) 0 Acres Private Land (+/-} 0 Acres <br />i-Pad Reclamation Specialist 6185E <br />X23 Centennial Building, 1313 Sherman Slreel Denver, Colorado 80203 1 et (303) 866-3567 <br />