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<br />r <br />STATE OF COLORA,Dp"= <br />Roy Romer, flow <br />DEPARTMENT OF NATURAL RESOURCES <br />MINED LAND RECLAMATION DIVISION <br />Douro c ane~roK o+r.ow. <br />APPLICATION FORM FOR A REYISION <br />TO A COAL MININ6 AND RECLAMATION PERMIT <br />This form Host be completed and sudaitted with all reaests.for minor <br />rcvlstons, as defined 1n Rule 1.04(73), technical rcrlsions as defined 1n <br />Rule 1.04(36) and permit revisions. as defined in Rule 1.04(90). All <br />rcvlslons arc to address the reaulreaients of Rule 2.08.4. <br />A11 revisions ere to be formatted so they can be inserted into the permit to <br />replace the revised sections, maps. tables end/or figures. Explain 1n the <br />revision what section is being revised. The revision date should be printed <br />1n the lower right corner of the revision pages, If necessary, the Table of <br />Contents should also be revised. <br />ate: 9/20/ 92 D~~ ' <br />Petwlttee: ~' D~~~ill`! ~%BL¢L _~ it ~(!/C' °. <br />~ J i <br />street: ¢ ~ ~ ._ S _ H E ~. ~ o tJ ~. ~.Y. SEP 2 2 1992 <br />____ . Ui~~.,,.,.. <br />City: E D N S / i c.. L E ~ MINERALS & GEO~~~~ .v <br />state: 1 '~) Zip Code: 4 7 7 L.5 <br />Petalt No.: C - 8 ~ - ~ 3 ~ <br />Revision Number _ _ (Sequential by Revision Type) <br />Revision Sudnittal Date _/_/ (Date Received by Division) <br />Revision Completeness Date _/ /_ Revision Incompleteness Date _/ / <br />Revision Adequacy Due Date _/ /_ Revision Adequacy Date _/ /_ <br />Revision Decision Due Date / / Fee s0.00 <br />Brief pescription of Revision: a E V - ,~E _,~~ ~'L~_ <br />Public Notice Attached -Yes _ No ~(Reaulred far PR's and TR's) <br />This box to be filled in by the Dl vision: <br />Type of Revision: (PR, TR, or MR) <br />Bond Increase: Tes _ No 0 <br />Proposed Change 1n: <br />0lsturbed Arce (+/-) _ _ _. 0 Acres Affected Area (+/-) _ _ _,Q Acres <br />Permit Area (+/-) _ _ _.~ Acres Federal Land (+/-) _ _ Q Acres <br />. SU~ end ~) _(O Acres Private Land (+/-) ~ Acres <br />emW IeG.~3TJ' rrnan Street Osmer, Cobndo 80203.4273 7eL (307) an0.7deT <br />Lead Reclasation Specialist 6185E <br />