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L STATE DIVISION OF MINERALS AND GEOLOGY Oepanment of Natural Resources 1311 Sherman SI.. Room 215 Denver, Colorarlo 80203 ~r o~ ~'~o Phone:17071866-3567 Ory~ 1,9gQ FA%:13031832.8106 APPLICATION FORM FOR A R V TO A COAL MINING AND RECLAMATION~~I~ ~OoD~Dl9Y ~ . ~ ~~ :.,t•,. ~~ This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer Rule 1.04(731, technical revisions, as defined in Rule 1.04(361, and permit revisions, as defined covemor in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three (31 copies lames 5. Lachhead of the revision, including maps, must be submitted in order for it to be complete. EaeCU~ive Di,eC1« Michael 9. long - Division DirtCmr All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal date should be printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature of the revision and reference the specific permit sections being revised. Far federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing list at the same time the application is submitted to the Division, and proof of distribution must be submitted to the Division along with the application. Copies of revision pages modified during the review process must be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted prior to implementation of the revision. For non-federal mines, a copy of the application for which the Division has issued a proposed approval decision must be submitted to the OSM Albuquerque Field Office IAF01, and proof of submittal to AFO must be submitted to the Division prior to implementation of the revision. Permit No.: C-~ Q-~ Q Z Date: 0~/ 0 3/ 9 6 Permittee' MOUNTAIN COAL COMPANY _ _ _ _ _ _ J - - - - - - - - - - - - - - - Street: ~0,_$0~,59L_-__-__-__ - - - - - - - - - - - - - - - City: SOMERSET _ _ _ _ _ _ _ _ _ State: -C ~ Zip Code: ~.143s _ _ _ _ _ _ _ Brief DeSCriptiDn Of Revision: SLOPE STABILITY IMPROVEMENTS- - - - - - - - - - - - - - - Public Notice Attached: Yes _ No ~ (Required for PRs and TRsI Bond Increase: Yes No x Federal x Nan-Federal Mine Proposed Change in: Disturbed Area (+/-) _ _ _p . 1L Acres Permit Area (+/-) _ _ ~ . ~-Acres State Land (+/-) _ _ ~ ~ Acres Affected Area (+/-) _ _ ~ . ~ Acres Federal Land (+/-) ~ _ 0 , 0 Acres 0 0 Private Land (+/-) ~- _ _ -Acres m:\eoel\sh ere\form s\8865