REV01982

• Permit No: C1981014
• IBM Index Class Name: Revision
• Doc Date: 10/13/1993
• Doc Name: APPLICATION FORM FOR A REVISION TO A COAL MINING & RECLAMATION PERMIT
• Type & Sequence: TR16
• Media Type: D
• Archive: No

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STATE OF COLORALx~
Roy Romer, Gave
DEPARTMENT OF NATURAL RESOURCES
MINED LAND RECLAMATION DIVISION
RUED R BIINTR Olnetor
APPLICATION FORM FOR A REVISION
TO A COAL MINING AND RECLAMATION PERMIT
This fora must be completed and submitted xith all requests for minor revisions, as defined
in Rule 1.04(73), technical revisions as defined in Rule 1.04(36) and permit revisions, as
defined in Rule 1.04(90). A11 revlsions are to address the requirements of Rule 2.08.4.
Three copies of your recision including maps must be submitted in order for it to be complete
All recisions are to be formatted so they cart be irser+.ed into *he permit to replace the
revised sections, maps, tables and/ar figures. •:xpiain in the revision what section is being
revised. fie revision date should be printed in the laver right corner of the revision
pages. If necessary, the Table of Contents should also be revised. When the final version
of the revision is approved, 1 copies must be sent to OSM in Denver for Federal mines and for
non-Federal mines 1 copy must be sent to OSM at 625 Silver Avenue, S1I, Suite 310,
Albuquerque, New Mexico 87102. The revision may not proceed until OSM has been provided
copies. Copies should be sent certified mail.
Date: ~ ~/ ~3 / 93
Permittee: ~ ~En„gr~ FY~els Coal Inc.
Southfield Mine
$ireet: P.O. Box 449 `
Cib: Florence __________^__`_
State: co, tip Code: 81226_ _ _ _ , _ _
Perslt Mo.: C - 81 - 014
s ox e 1 1n y e 1v1s1on:
lype of Revision: _ _ (PR. TR, or MR)
Revision Number _ _ (Sequential by Revision Type)
Revision SubmiLtaT Date _/ / (Date Received by Division)
Revision Completeness Date _/_/_ Revision Incompleteness Date _/~/_
Revision Adequacy Due Date _/ / Revision Adequacy Date _/ /_
Revision Decision Oue Date / / Fee 50.00
Br1ef Description of Revision: Incide_tal Permit Boundary Change _ _ _
date_Disturbance Boundary
Public Notice Attached -Yes X- ~o (1~equire~ ~iir~R s and~lt s)- - -
Bond Increase: Yes No g ~eaeral Non-Federal Mine
Proposed Change in:
Disturbed Area (+/-) _ ~2 . 0 Acres Affected Area (+/-) Acres
Permit Area (+/-) _ _3_. z Acres Federal Land (+/-) - --~- Acres
State Land (+/-) Acres Private Land (+/_) - -' - Acres
Lead Reclamation Spec~al~st Jcs _ 6185E (rev 288)
423 Centennial Bufldinq, 1313 Sherman Street Denver, Colorado 80203-2273 Tel [phone]