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OCPAfTTMENf OF NAfUfTAl1TESOURCES <br />bavld N. Oelchea. EaecVllve blreclor <br />MINED LAND RECLAMATION DI1 <br />DAVIb C. SIIE LtO N, blreelor <br />n4ha.d n. Lamm <br />c°"°'°°' APPLICATION FORM FOR A REYISION <br />TO A COAL MINING AND RECLAI4AilON PERMIT <br />this form must be completed and submitted I+ith all requests for minor revisions, as <br />defined in Rule 1.041731, 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 the requirements <br />of Rule 2.00.4. <br />A11 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 loner right corner of the <br />revision pages. If necessary, the 1ab1e of Contents should also be revised. <br />Date: 1 0/ 1 2/ 8 7 <br />Perml ttee: P e a b o d y-C o a t--- ,,,~~ f~,~ P gQ <br />C o m ~ a n y - - - - - _ - <br />Street: 1 3 0 0- S o u t h- Y a l e OCf 13 1981 <br />--------------- •'vi:?~EDIAtVD <br />City: F 1 a ~ s t a f f _ _ _ _ _ _ _ _ _ ~FC'.A~4A?-!Ohi DIVISION <br />ate: A Z Zlp Code: 8 6 0 0 1 _- - <br />rmi t 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 b1v151on) <br />Revision Completeness Date -/_/_ Rev151on Incompleteness Date -/_/ <br />Revision Adequacy Due Date -/_/_ Revision Adequacy bate _/-/_ <br />Revision Decision Due Date / / Fee E0,00 <br />Brief Description of Revision: E t <br />-- A H a u <br />----- l R <br />--- o a d <br />--- <br />-- <br />R <br />- e l o <br />--- c a t i o <br />----- n <br />--- <br />--- <br />-- <br />Public Ilottce Attached - Yes + No X IP,equired For PR's and TR's) <br />Bond Increase: Yes _ No X <br />Droposed Change In: <br />Disturbed Area (+/-) _ _ 0 . 0 Acres Affected Area (+/-) _ _ 0 . 0 Acres <br />rmlt Area (+/-) _ 0 . <br />- 0 Acres Federal Land (+/-) _ _ 0 Acres <br />ate Land (+/-) <br />0 Acres Private Land (+/-) 0 Acres <br />Lead Reclamation Specialist 6185E <br />423 Genlennial Building, 1313 Sherman Slreel Denver, Colorado 60203 Te1.1303) 666.3567 <br />