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JAN-29-'93 10:12 ID: CO MINED LRND REC'L TEL N0:303-832-8106 <br />STATE OF <br />III IIIIIIIIIIiII III <br />999 <br />DIVISION OF MlNERAL,S AND GEOLOGY <br />Department o! Natural Resources • <br />1713 Sherman 51., Room 215 ~ ~~ <br />Denver, C4 a0101 <br />Phone:13o31 e66.756~ <br />FA%: 17071 t172-8106 <br />APPLICATION FORM FOR A REVISION t+w Romw <br />TO A COAL MINING AND RECLAMATION PERMIT c°"""°` <br />Mfeh•pl e. luµ <br />DNlslon Dlre[sor <br />This form must he completed and submitted with all requests for minor <br />revtslons, as defined 1n Rute 1.04(73), technical revisions as defined in <br />Rule 1.04(136) and permit revtslons, as defined in Rule 1.04(90>. A11 <br />revisions are to address the requirements of Rule 2.08.4. Three Cal copies of <br />your revision 'lncluding maps must be submitted in order for it to be complete. <br />All revtslons 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 />- to 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, the Federal cperation 1s responsible for providing one copy to each <br />of the agencies noted on the Federal Agencies Mailing List. For non-Federal <br />mines, the vperatlon is responsible for providing one copy to o5N 1n <br />Alhuquerque <625 511ver Avenue, 5W, Suite 310, Naw Mexico 87102). The <br />revision may not proceed until OSM has been provided copies. Copies should be <br />sent certlfted mail. <br />Permit No.: C - ~ `~ - - - - dT ~.~ <br />Date: _O ! / 7- 4 / ~ 3 <br />Permittee• Rrrt+R~GK Cs /'Y ~D^-~P/1"~ ~ 5 199 <br />----'----•-------'~---FED®- <br />Street: / 3 S1~ /'~t5 tr. /~~or sT517 - ':Iti~RALS 18 <br />----- ----- -~-t.?l: <br />City: 17r~NV1~/~ ---------------- <br />State: CO Zip Code: Sro xo ~ - - - - - <br />Hine Name: _ ~rsc_r(oU! _Co.a-~c !'G~,u~_ _ - _ ^ - - - _ <br />Brief Description of Revlsian: f?r; ~~«rn 36" C~u(v~?~ ~ J ~~?~_S'~G' <br />Public Notice Attached - Yes _ No ~ (Required for PR's and TR's> - <br />Bond Increase: Yes _ No ~C Federal ! Non-Federal ~ Mine <br />Proposed Change in: IVfQ- <br />btsturbed Area C+/-) - - - - Acres Affected Area (+/-) - ~. - _. Acres <br />Permit Area (+/-) - - - - Acres Federal Land (+/-> _ ,_ - Acres <br />State Land (+/-) - - ,~ Acres Private Land (+/-> - _, - Acres <br />6185E (01/93) <br />