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~~., -~, <br />°` `°`° STATE OF COLORADO <br />•1 ~ ~• Roy Romer, Governor <br />•~er <br />i ~ I <br />i ~ <br />DEPARTMENT OF NATURAL RESOURCES <br />-~, <br />MINED LAND RECLAMATION DIVISION ;~,~', ~~y>' <br />FRED R. BANTA, Dlnctor ' ~ 1•~t ,' '•; ,~ <br />APPLICATION FORH FORA REVISION ` '.r u <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor revisions, as defined <br />in Rule 1.04(73), techn'ic81 revisions as defined in Rule 1,04(36) and permit revisions, as <br />defined in Rule 1.04(90). All revisions are to address the requirements of Rule 2.08.4. <br />Three copies of 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 replace the <br />revised sections, maps, tables and/or figures. Explain in the revision what section is Deing <br />revised. The revision date should be printed in the lower right corner of the revision <br />pages. If necessary, the Table of Contents should also be revised. 'dhen the final version <br />of the revision is approved, 7 copies must be sent to OSt•1 in Denver for Federal mines and for <br />non-Federal mines 1 copy must be sent to OSM at 625 Silver Avenue, SW, Suite 310, <br />Albuquerque, New Mexico 87102. The revision may not proceed until OSM has been provided <br />copies. Copies should De sent certified mail. <br />Date: Q Z/ ~. L/ .~ T< n <br />PermitLee: ul ,/~, Q y~ ~, d/ [t - ~ (L ~, L - ~ U i ~i~s! ~ V E® <br />~.ti-eet: L~3r2~-tileC.~.-L?---- JUL271992 <br />City: ~/~~_~~------------MINERALS8vE0LUGY <br />State: ~ Q Zip Code: ~ ~ Q ~ I - - - - - <br />Permit No.: C - gf - ~ L ~ <br />Mine Name: /r ~ ~ n c ,~ <r .~ ~ ~ F <br />is oox to oe rtllea to oy the Dtvtston: <br />Type of Re vision: r~ (PR, TR, or MR ) <br />Revision !lumber: Z O (Sequential by Revision Type) <br />Rev. Submittal Date: _ _/_ _/_ _ (Date Received by Division) <br />Rev, Completeness Date: / / Rev, Incompleteness Date: / / <br />- - - - - - - - - - - - <br />Rev. Adequacy Due Oate: - -/- -/- - Rev. Adequacy Date: - -/- -/- - <br />Rev. Decision Due Date: - -/ -/ - Lead Reclamation Specialist: - - - <br />rte escrtp ton o evtston: & ~ - C <br />O ~ L - - ~ C G ~ / /y/ <br />Publi <br />Bond c Notice <br />Increase: Attached - <br />Yes ti S~,yI/ <br />Yes r%~o =~q~re~ 1'or~R s and-TR s) <br />Ilo _ -lederal Non-Federal Mine <br />Proposed Change tn: <br />sturbed Area (+/_) O, Acres Affected Area (+/-) p. Acres <br />rermit Area (+/-) - _ CZ,_ Acres Federal Land (+/_) - -_ Q - Acres <br />State Land (+/_) - - ~ Acres Private Land (+/-) _- _ p Acres <br />6185E (Rev. 10/88) <br />215 Centennial Building, 13t3 Sherman Street Denver, Colorado 802032273 Tel. (3031 8663567 <br />