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l <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />F'00 <br />Department of Natural Resources p <br />~~/_~~,.~9~ <br /> <br />7313 Sherman St.. Room 215 <br />Denver. CO 80203 «q <br />~ ~ ~~~~ <br />J03 866-3567 .may <br />FA X: 303 832.8106 <br /> Pay Romar. <br /> Governor <br /> Frec R. Barra. <br />APPLICATION FORM FORA REYISION Grvision Duector <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor <br />revisions, as defined in Rule 1.04(73), technical revisions as defined in <br />Rule 1.04(36) and permit revisions, as defined in Rule 1.04(90). All <br />revisions are to address the requirements of Rule 2.08.4. Three (3) copies of <br />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 <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 />in 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 is <br />approved, 7 copies must be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 copy mist be sent to OSM at 625 Silver Avenue, SW, Suite <br />310, Albuquerque, New Mexico 87102. The revision may not proceed until OSM <br />has been provided copies. Copies should be sent certified mail. <br />Permit No.: C- 8 1- ~., Z l <br />Ddte: 0 3/ 2 0/ 9 1 <br />Permittee: C O L O S g, ~, ~ _, Y A M P g _, <br />C O A L_ C O M P A N Y___ ~~~~le ,~M1 <br />1 <br /> <br />Street: 2 9 5 7 4 R ~ <br />O U T T <br />~ t <br />c o u N T Y R O A D _? ~_ MAR 251991 <br />City: O A K <br />C R E E K <br />_ <br />State: C o Zip Code: a __ _____ __ <br />o a 6 ~ ___-,Recf~nad Land <br />mati <br />a <br />Mine Name: MINES 1 2, 6 ~l[ <br />on Division <br />E C K M A N pp <br />Brief Description of Revision: S M A L L _ A ~ ~, g _ _ _ _ _, _ <br /> E X E M P T I S N_ ____ _._ <br />Public Notice Attached -Yes No X (Required for PR's and TR's) <br />Bond Increase: Yes No X Federal X Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ N/A ._ Acres Affected Area (+/_) _ ~ ,_ Acres <br />Permit Area (+/-) _ N/A ._ Acres Federal Land (+/-) _N1A Acres <br />State Land (+/-) N/A Acres Private Land (+/-) N/A Acres <br />