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<br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, CO 80203 <br />303 8fi6-3567 <br />FA%:303 832-6106 <br />pF' ~O(Q <br />ti~ <br />ti <br />Ne ~ ~~ <br />• ( sy+ ~ r <br />. T ry,~ <br />~IB76 <br />Roy Romer, <br />Gwemw <br />' Freo R. Barra. <br />APPLICATION FORM FOR A REVISION Div~s~on Director <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 2- 0 5 7 <br />Date: 1 0/ 0 7/ 9 3 <br />Permittee: P E A B O D Y W E S T E R N <br />- - - - - - - - - - - - - - - <br />C 0 A L_ C 0 M P A N Y ~J~!'~~~I~r~. <br />Street: 1 3 0 0 S O U T H Y A L E ~ r~ <br />--- --------- JC~1 rlgy1 <br />City: F L A G S T A F F___ ~"°~ ~_ __ <br />., - - <br />State: A Z Zip Codei 8 6 0 0 1 - - - -` , ut~~ ,~ <br />Mine Name: S E N E C A I I W - <br />- - - - - - - - - - - - - - - - - - - - <br />Brief Description of Revision: A D D R E S S - D I V I S I O N S <br />- - - - - - - - - - - - - - <br />M I D T E R M- R E V I E W-- <br />C O M M E N T S - - - - _ _ - - <br />Public Notice Attached - Yes X No _ (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 (+,L%) 1 ~ ~, 2 Acres Affected Area (+/_) - - - _ Acres <br />Permit Area (+/-) - - Q, 0 Acres Federal Land (+/_) - - 0 Acres <br />State Land (+/-) 0 Acres Private Land (+/_) Acres <br />6185E (10/90) <br />