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r Of COI%~U~ <br />T ~%Il :i9! ~ <br />o DCf'MIMENf OF NATURAL RESOURCES <br />~ ~ ~ a f~ ~ bav~d n Gerchea. E.ecurtie br.ecror <br />' ~`"='' ` MINED LAND RECLAMATION DI\ <br />• __ <br />B 76 ~ bAV10 C. SIZE LION, bite clot <br />nicha.An Lamm <br />c°.a.°°. APPLICATIOR FORFI FOR A REVISION <br />TO A COAL fIIIJ1IJG AiiD RECLAFIATIOIJ PERt•1IT <br />This form must be completed and submitted with all requests for minor revislons, as <br />defined In Rule 1,04(13-, technical revisions as defined in Rule 1.04(36) and permit <br />revisions, as defined In Rule 1,04(90), All revislons are to address the requirements <br />of Rule 2.00.4. <br />All revislons are to be formatted so they can be inserted Into the permit to replace the <br />revised sections, maps, tables and/or (Igures. Explain in the revlslon what section Is <br />being revised. The revlslon date should be printed in fire lower right corner of tl,e <br />revlslon pages. If necessary, the Table of Contents should also be revised. <br />Date: 0 5/ 0 6/ 8 J <br />Perml ttee: P e a b o d~_ C o a l <br />----- <br />C o m~ a n ~________ <br />Street: 1 3 0 0 S o u t h Y a l e <br />--------------- <br />--------------- <br />City: F l a g s t a f f __ ________ <br />te: A Z Zip Code: 8 6 0 0 T --_ ___ <br />~rmlt No C- 8 0- 0 0 5 <br />This box to be filled In by the Division: <br />Type of Revision: _ _ (PR, TR, or FIR) <br />Revision Number _ _ (Sequential by Revision Type) <br />Revision Submittal Date _/_/_ (Date Received by Division) <br />Revision Completeness Date _/_/_ Revision Incompleteness Date _/_/ <br />Revision Adequacy Due date _/_/_ Revlslon Adequacy Date _/_/_ <br />Revlslon Decision Due Date / / Fee E0,00 <br />Dr1ef Description of Revlslon: N o x L o u s W e e d <br />--------------- <br />C o n t r o l P l a n <br />----------------- <br />Public Notice Attached - Yes _ Ilo XX (Required for PR's and TR's) <br />Dond Increase: Yes ilo XX <br />Proposed Change In: <br />0lsturbed Area (+/-) _ _ 0 .0 <br />~nlt Area (+/-) _ _ 0 • 0 <br />ate land (+/-) 0 <br />Acres Affected Urea (+/-) <br />Acres Federal Land (+/-) <br />Acres Private Land (+/-) <br />Lead Reclamation Specialist <br />0 0 Acres <br />_ 0 Acres <br />0 Acres <br />6185E <br />~2~ Cerrlerrnlal Building, 131 Sherman Slreel denver, Colorado 0020 Te1.1~03) 866-3567 <br />