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<br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Dcpanmrm of Natural Resources <br />Ill 1 ih~~nn.~n $I ,Room 21 5 <br />Di~n.~r~ l U tl0?03 <br />P6o",• ~ VIII H66~3567 <br />14l i1nL M1?NIOV <br />o` `Oro <br />M< <br />RGrFIVF~"~.~vs" <br />(~/ ~I (~(~ ~sre' <br />N[71 I / ~.I•'' Roy Rome <br />APPLICATION FORM c°°""°' <br />RENEWAL OF A VALID, EXIST{~NG. PERM Michael B. long <br />TO CONDUCT MINING IN CO~~~~~II'~I'I~ u veuwgV Di.i.,°"oven°, <br />This form is an application for successive renewal of a valid, existing permit to conduct surface <br />or underground mining and reclamation activities or other surface coal mining and reclamation <br />operations in Colorado pursuant to C.R.S. 34-33-101, et seq. This application form is designed <br />to revise and update the application form currently included in your permit application. The <br />right of successive renewal applies only to lands and activity which were permitted during the <br />previous term. Extensions of the permit area and significant new activity within the permit area <br />are subject to the review procedures applicable to new permit applications, in accordance with <br />Rule 2.08.5(1)(c) and 2.08.4. Such changes will be handled by the Division as permit <br />revisions, and will be processed simultaneously with the application for renewal. Other <br />changes to the permit will be processed as technical revisions or minor revision in accordance <br />with Rule 2.08.4. <br />• For a renewal application to be deemed complete by the Division pursuant to C.R.S. <br />3433-109(7), an applicant must submit: (11 all information as specified on this application <br />Corm; 121 a copy of the newspaper notice; (3) evidence that a liability insurance policy will be <br />provided for the proposed period of renewal; and 14) five reproducible copies of the permit <br />renewal application with original signatures. At the completion of this process, the federal <br />operation is responsible for providing one copy of the final revised pages to each of the <br />agencies noted on the Federal Agencies Mailing List. For non-federal mines, the operation is <br />responsible for providing one copy to the Office of Surface Mining, 505 Marquette Avenue NW, <br />Suite 1200, Albuquerque, New Mexico 87102. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as listed below. Supplemental sheets may be <br />used as necessary. Such sheets must be attached to the form and referenced or keyed to the <br />numbers on the form. <br />1. Permittee: tCIM.QO~,oK' COAL, IAMPRrJY n ~OI-ORA00 l-DR~DRRTr01~ <br />2. Name of Operation: R,tMRpCK /bl1AlE <br />3. Permit Number (same as current permit number): C - ~~ - O 7 <br /> 4. Type of Revision: R N Renewal Number: 0 ~ <br />. 5. Application Submittal Date: f 2 / 1 ? / ~S <br />