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i <br />./ <br />OF CO< <br />R~' 0~9 <br />hQ ' ~ <br />y ~.. <br />i /~ ~ ~. <br />* r876 s <br />Richartl D. Lamm <br />Governor <br />APPLICATION FORM FORA REVISION <br />TO A COAL MINING AND RECLAMATION 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 permit <br />revisions, as defined in Rule 1.04(90). All revisions are to address the requirements <br />of Rule 2,08.4. <br />All revisions are to be formatted 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: 1 2/ 1 2/ 8 8 <br />Permittee: C O L O R A D O- V A M P A_ ~~~~r'~r.-~ ~ q~ <br />C O A L _,~, O M P A N Y ___ <br />Street: 2 9 5 7 9_" R 0" U T T____ U t: ~ 1 ;j 1968 <br />0 0 0 N T Y_ R 0 A D_ 2 7_ ,v,ivr, ~;i,`p <br />Ci tY ~ 0 A K _ C R E E K _ _ _ _ _ _ _ ~ iF'I'1-~~~~ I fG~Pd DIVI$!(jiV <br />State: C 0 Zip Code: 8 0 4 6 7- ____ <br />Permit No.: C- 8 1- 0 7 1 <br />This box to be filled in by the Division: <br />Type of Revision: _ _ (PR, TR, or MR) <br />Revision Number _ _ (Sequential by Revision Type) <br />Revision Submittal Date _/_/ (Date Received by Division) <br />Pevision Completeness Date _/ / Revision Incompleteness Date _/ / <br />Revision Adequacy Due Date _/ / Revision Adequacy Date _/ / <br />Revision Decision Oue Date <br />Brief Description of Revision: A R E A 5 1 E M I N E <br />- - - - - - - - - - - - - - - <br />P L A N_ M O D I F I CAT I O N____ <br />Public Notice Attached - Yes No X (Required for PR's and TR's) <br />Bond Increase: Yes No X <br />Proposed Change in: <br />Disturbed Area 4'-) _ ~ 3 , 5 Acres <br />Permit Area (+/-) _ _ _,~ Acres <br />State Land (+/-) 0 Acres <br />lead Reclamation Specialist <br /> <br />DEPARTMENT OF NATURAL RESOURCES <br />Davitl H. Getches. Executive Director <br />MINED LAND RECLAMATION DI\ <br />DAVID C. SHELTO N, Director <br />Affected Area (+/-) _ _ _, 0 Acres <br />Federal Land (+/-) _ _ ~ Acres <br />Private Land (+/-) 0 Acres <br />6185E <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />