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iii iiiiiiiiuiuiii <br />999 <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />F'~o~ <br />Department of Natural Resources N`~ ~1g <br />1313 Sherman St.. Room 215 ~ ~,,, ~ ,~" ~ <br />Darner. CO 80203 _L'~Le'J~.7 <br />303 666.3567 ~ ~ rs~e <br />FAx: 303 832-8106 <br />Rq Roms, <br />Gowns <br />' FrW R. BantZ <br />APPLICATION FORM FOR A REVISION orwo^on.aor <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form Host be completed and submitted with all requests for minor <br />revisions, 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). All <br />revisions are to address the requirements of Rule 2.08.4, firee (3) copies of <br />your revision including maps must be submitted 1n order for it to De complete. <br />All 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 1s being revised. The revision date should be printed <br />in the lower right corner of the revision pages. If necessary, the Table of <br />Contents should also be revised. When the final version of the revision 1s <br />approved, 7 copies must be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 cropy m~si be sent to OSM at 625 Silver Avenue, Sk. Suite <br />310, Albuquerque, New Mexico 87102. The revision may not proceed until OSM <br />has been provided copies. Copies should be sent certified mail. <br />Permit No.• C - S 1 - ~~ - <br />Date: ~4-/ ~-/ ~~ <br />Permtttee: ~n€L9.Y..Fu~I5..G4~1 1.DG.~ - - - - - -~G _ V~ ~b~, <br />- - - - - - - - - - - - - - - <br />Street: v.~Sx~4~-----_---- 4PR 6199? <br />City: Flore~e - - - - ,_ - - - _ - - Mined Land <br />State: ~U, Zip Code: - ~~ - - - - - - <br />Mine Name: Southfl'el~h]j,Ite -------------- <br />Brief Description of Revision: ~e~~y~o~o~Caal~fuse_pile.Stahili.t,y-- <br /> <br />Public Notice <br />Attached - <br />-Yes ~_ - - - - - - <br />No ___._ (Required - - - - - - <br />for PR's and TR' - - - <br />s) <br />Bond Increase: Yes No ~ Federal Non-Federal ~ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) - _ ~.~ Acres <br />Permit Area (+/-) - - ~,~ Acres <br />State Land (+/-) 0..0 Acres <br />Affected Area (+/-) <br />Federal Land (+/-) <br />Private Land (+/-) <br />- _ ~.~ Acres <br />- - O.U Acres <br />- , U.0 Acres <br />ciacc rinr0nl <br />