Laserfiche WebLink
:`. <br />.~ ~ of co~~ <br />~~ ~ . ~~ <br />Fe -Svll'::a ~p~ <br />(~-J1 ~ <br />r ' ri <br />• `~/.r) <br />x X876 `/ <br />Ricnartl D. Lamm <br />Governor <br />APPLICATION FORld FOR A REVISION <br />TO A COAL MINING AND P.ECLAt4ATI0N PERMIT <br />This form must be completed and submitted with all requests for minor revisions, as <br />defined in Rule 1.04(73), technical revisions as defined in Pule 1,04(36) and per-nit <br />revisions, as defined in Rule 1.04(90). All revisions are to address the requirements <br />of Rul a 2.08, 4. <br />All revisions are to be fort:tatted 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 lower right corner of the <br />revision pages. If necessary, the Table of Contents should also be revised. <br />Date: 0 6/ 0 8/ 8 7 <br />Perini ttee: C O L O R A D O Y A M P A_ ~» ~,. ~ g <br />`~ ~'~` ~~~~® <br /> ~~ A ~_ C O M P A N Y ___ <br />Street: Z-- 9 5 8 8_ R O U T T____ JUPd 1 S 1987 <br /> 0 0 0 N T Y _ R 0 A D_ 2 7_ d+liMtD LAiVD <br />City: Q ~ K C R E E K _ _ _ _ _ _ _C~ECLA:'v1AT101V DIVISION <br />State: ~ ~ Zip Code: g 0 4 6 7 - _ _ _ _ ~,1 <br />Permit No.: C - ~ ~ - 0 7 I <br />This box to be filled in by the Division: <br />Type of Revision: _~/e (PR, TR, or hJR) <br />Revision lJumber o~ O (Sequential by P.evision Type) <br />Revision Submittal Date (Q /l~/d'7(Date <br />P,evi si on Completeness Date (~/~/ ~' 7 <br />Revision Adequacy Due Date ~~/~~] <br />Revision Decision Due Date / / <br />Received by Division) <br />Revision Incompleteness Date _/ / <br />Revision Adequacy Date ~D //~/~7 <br />Fee 50.00 _ <br />Brief Description of Revision: M I N E 2 G R A Z I N G <br />- - - - - - - - - - - - - - - <br />~ L A N _ _ _ _ _ _ _ _ _ _ _ _ _ <br />Public Notice Attached - Yes _ No ~(P.equired for PR's and TR's) <br />Bond Increase: Yes No ~_ <br />Proposed Change in: <br />Disturbed Area (+/-) - _ ~, 0 Acres Affected Area (+/-) _ _ 0.0 Acres <br />Permit Area (+/-) _ _ ~,,~ Acres Federal Land (+/_) _ _ 0 Acres <br />State Land (+/_) _ _ ~ Acres Private Land (+/_) _ _ 0 Acres <br />Lead Reclamation Specialist Q L~ 6185E <br />423 Centennial Budding, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866.3567 <br />• <br />DEPARTMENT OF NATURAL RESOURCES <br />Davitl H. Gelcnes. Eaecutrve D~reclor <br />MINED LAND RECLAMATION DID <br />DAVID C. SHEl70 N, Director <br />J~--~ <br />y <br />i ~ III III II IIIIIIII III <br />~y d ~ <br />