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III IIIIIIIIIIIII III <br />999 <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Oepanmenr of Natural Resources <br />t7t3 Snerman Sr.. Room 2t5 <br />Denver. co 6ozo3 <br />703 868.7567 <br />F,ax 303 632.6to8 <br />%~EC:EI l/E( i <br />JUL 0 8 199 <br />pf CO <br />'~~' t <br />°°~a <br />~. `~~ f <br />reps <br />ft~aur. <br />F~ae R. Barra. <br />pfrtamn oir.ctor <br />Divisor; of haneral; ~ "e0i~9t' <br />APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests far 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 Ru]e 2.08.4. firee (3) copies of <br />your revision including maps must be submitted in order for it to be 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 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 />Contents should also be revised. When the final version of the revision is <br />approved. 7 copies must be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 copy mist be sent to OSM at 625 Sliver Avenue, SW, 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- e z- 0 5 6 <br />Date: - _~ -_ _~ _-_- <br />Permittee: T yy ~~ L~~ 1 J.. Z- C O A L <br />Street: z 9 S 1 ,3r _ ..B ~ Y 1 1 _ - - - <br />C O ~N Z~.-~~~13.._Z.Z- <br />State: C O. Zip Code: ~ ~ Z !a_ L - - - - - <br />Mine Name: F O I D ,~ I~-~B~Z~-~L~E--- <br />Brief Description of Revision: M R - 9 3 _ 9 O - - - _ _ _ - - <br />T I P P L E _~-SL~~,LZ,LJi <br />I N V E S T jam, A LL~~.--- <br />Public Notice Attached - Yes No x (Required for PR's and TR's) <br />Bond Increase: Yes , No x Federal ~ Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/_) N/A _ Acres Affected Area (+/_) _ N/A _ Acres <br />Permit A,'ea (+/-) N/A _ Acres Federai Land (+/_) _ N/A i Acres <br />cra+a,ra„a !+/_1 ^N/A Aces Private Land l+/_) N/A - Acres <br />