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<br />,. ;... . <br />`~:" . <br />~~ <br />U <br />STATE OF COLORADO <br />PdINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />1J1J Sherman St., Room 275 ' <br />~. ~•~ver, CO 80203 <br />30J 866-J567 <br />FAX: J07 8J2.8106 <br />o~'cOto <br />~ i-A:. <br />~'~ Q>'1S <br />.~ <br />reic' <br />Rq~ Romer, <br />Gwamu <br />' Fred R. Banta. <br />APPLICATION FORfd FOR A REVISION olvislon o~ranor <br />TO A COAL MINING ANO RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor <br />re•+i~ions, as defined in Rule 1.04(73), technical revisions as defined in <br />Rule 1.04(36) and permit revisions, as defined in Rule 1.04(90). A11 <br />revisions are to address the requirements of Ru1~e 2.08.4. Three (3) copies of <br />your revision including maps must be submitted in order for it to be complete. <br />A11 revisions are to be formatted so they can be inserted into the permit to <br />replace the revised sections, maps, tables and/or figures. Explain in the <br />revision what section is being revised. The revision date should be printed <br />in the lower right corner of the revision pages. If necessary, the Table of <br />Content- should also be revised. When the final version of the revision is <br />arrroved, 7 copies must be sent to OS~1 in Denver for Federal mines and for <br />non-Federal mines 1 copy trust be sent to OSM at 625 Silver Avenue, SW, Suite <br />310, Albuquerque, New Mexico 87102. The revision may not proceed until OSM <br />has been provided copies. Copies sheuld be sent certified mail. <br />+~ 'Permit No.: c- g L- 2 2 2 <br /> Date: i ~./ 1 g/ Q L - ~ - <br /> -- <br />Permittee: ~~1-~QA L ~Q.-.--- i`S - -' <br />"~-~ <br /> .~L <br />. street: L o ~? Q ~. ~F>~ Z a ~ Z'K f'~.E'JAN Q 6 199; <br /> .~'/ 2d <br /> <br /> <br />• ________ <br />,I,:inerr Lard <br />City: ~~E~ T~ ~ l~Cz E. - - - - ~''_ _ <br /> <br />' '~--.~- <br />State: ~ C Zip Code: ~ Q Q ~ ~ - <br />' <br /> - - - - <br />Mine Name: ~ E E.L2 %? L ,~.'~` 1 - - - - - - - - - - - <br /> Brief Description of Revision: ~~/ ~~ E ~, ~ ~ -~~ ~~ 7 ~- <br />. ~L~iC-~~'Y. %~.E-Ea.B- <br /> <br /> Public Notice Attached - Yes ~ No (Required for PR's and TR's) <br /> Bond Increase: Yes No ~_ Fedeta~. Nan-Federal 1{ Mine <br /> Propc:^~1 rhange in: <br /> Disturbed Area (+/_) Q - - - Acres Affected Area (+/-) p <br />Acres <br /> _ _ _ <br />Permit Area (+/_) o - - - gcres Federal Land (+/_) Q <br />Acres <br /> _ _ <br />State Land (+/_) O - - ~ Acres Private Land (+/_) ~ _ _ Acres <br /> 6185E (10/90) <br />'~''"': <br /> /77-~ ~-4~ v. ia~9r <br />