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_ III IIIIIIIIIIIII III STATE OF COLORADO <br />DIVISrun ur m9VtKALS AND GEOLOGY <br />Depanmem of Nawral Resources Iwo . ~ <br />1 J 1 J Sherman SI., Room 215 <br />Denver. Colorado 8020] RECEIVED <br />Phnne: r7DJ1 e66-3567 <br />FAX: U0718J2~8106 APPLICATION FORM FOR A REVISIO~r ii__~~ <br />TO A COAL MINING AND RECLAMATION P2RIVn'L~ ~~~ DEPARTMENT <br />pIVl6ltld tlt Mltltltdl5 d C7tloI0Qy <br />This form must be completed and submitted with all requests for minor revisions, as defined in <br />Rule 7.04173), technical revisions, as defined in Aule 1.04(136), and pertnitrevisions, as defined <br />in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three (31 copies <br />of the revision, including maps, must be submitted in order for it to be complete. <br />Rov Romer <br />Govemar <br />lame 5. Luchhead <br />Executive Direcln <br />Michael B. lanr; <br />Division OireRUr <br />All revisions are to be formatted so they can be inserted into [he permit to replace the revised <br />sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal <br />date should be printed in the lower right corner of each revision page. A cover letter to the revision should <br />explain the nature of the revision and reference the specific permit sections being revised. <br />For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing <br />list at the same time the application is submitted to the Division, and proof of distribution must be submitted <br />to the Division along with the application. Copies of revision pages modified during the review process must <br />be distribu[ed in the same manner, along with proof of distribution. Proof of distribution must be submitted <br />prior to implementation of the revision. For non-federal mines, a copy of the application for which the <br />Division has issued a proposed approval decision must be submitted to the OSM Western Regional <br />Coordinating Center 11999 Broadway Blvd., Suite 3320, Denver, CO 80202-57331, and proof of submittal <br />to OSM must be submitted to the Division prior to implementation of the revision. <br />Permit No.: C- 8 2 0 5~ Date: 1 0/ 2 2/ 9 6 <br />Permittee: T W ~ N ~ Y M I L ~ _ _ _ _ _ <br />C O A ~_ C O 11 P A N Y___ <br />Street: ~ 9 5 1 5 R O U T ~, _ C O U N T~ <br />R O A D _ # 2 7 _ _ _ _ ~ _ _ <br />City: O A I( _ C R E E K ______ <br />State: C O Zip Code: 8 0 4 6 ~ - ~ _ _ <br />Brief Description of Revision: STOKER TRUCK SELF-LOADING SYSTEM AND <br />ADDITIONAL ENGINEERING TRAILER <br />Public Notice Attached: Yes _ No X (Required for PRs and TRs) <br />Bond Increase: Yes X No_ <br />Proposed Change in: <br />Disturbed Area (+/_) _ _ 0 <br />Permit Area (+/_) _ _ 0 <br />State Land (+/_) _ _ 0 <br />Federal X Non-Federal <br />0 Acres Affected Area <br />~ Acres Federal Land <br />0 Acres Private Land <br />Mine <br />(+l-) _ _ <br />(+/") - - <br />(+/"~ - - <br />0 0 Acres <br />0 0 Acres <br />0 0 Acres <br />m ~Irnallcha relfnrms18865 <br />