REV04560

• Permit No: C1980007
• IBM Index Class Name: Revision
• Doc Date: 9/18/1995
• Doc Name: APPLICATION FORM FOR A REVISION TO A COAL MINING AND RECLAMATION PERMIT
• Type & Sequence: MR164
• Media Type: D
• Archive: No

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. III IIIIIIIIIIIII III
999
STATE OF COLUIZADO
MR 164 ~~~~~~
FAX: [phone] APPLICATION FORM FOR A REVISION
TO A COAL MINING AND RECLAMATION PERMIT DEPARTMEIVI' Oi
DIVISION OF MINERALS AND GEOLOGY
Depanmem of Natural Resources
1 717 Sherman St.. Room 215
Denver, Colorado 80203
Phone: [phone]h~ 7567
NATURAL
RESOURCE`_
This form must be completed and submitted with all requests for minor revisions, as defined in goy BOmer
Rule 1.041731, technical revisions, as defined in Rule 1.041361, and permit revisions, as defined covemor
All revisions are to be formatted so they can be inserted into the permit to replace the revised
sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision
submittal date should be printed in the lower right corner of each revision page. A cover letter to the
revision should explain the nature of the revision and reference the specific permit sections being revised.
in Rule 1 .041901. All revisions are to address the requirements of Rule 2.08.4. Three 131 copies lames 5. Lochhead
of the revision, including maps, must be submitted in order for it to be complete. ExeCO11Ve °ietor
Michael B. Lang
Division Dveclor
For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing
list at the same time the application is submitted to the Division, and proof of distribution must be submitted
to the Division along with the application. Copies of revision pages modified during the review process must
be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted
prior to implementation of the revision. For non-federal mines, a copy of the application for which the
Division has issued a proposed approval decision must be submitted to the OSM Albuquerque Field Office
(AFOI, and proof of submittal to AFO must be submitted to the Division prior to implementation of the
revision.
Permit No.: C- 8 0. 0 0 7 Date: 0 9/ 1 3 / 9 5
Permittee: MOUNTAIN COAL COMPANY
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
Street: -P.O. sox 591- - - - - - - - - - -l~-F(',F~~IE1~
--------------- SEP 18 `i995
City: -Somerset - - - - - - - - - - - -
CO p 8 1 4 3 4 0 5 9 l~ivision of Minerals 6 Geoloyy
State: - - Zi Code: - - - - - - - -
Brief Description of Revision: Light poles on materials storage bench - - -
Public Notice Attached: Yes - No R /Required for PRs and TRs/
Bond Increase: Yes No X Federal x Non-Federal Mine
Proposed Change in:
Disturbed Area (+/-) - - ~ ~ Acres Affected Area (+/-) - - ~ ~ Acres
Permit Area (+/-) - - ~ ~ Acres Federal Land (+/-) - - ~ ~ Acres
State Land (+/-) - - 0 0 gcres Private Land (+/-) - - 0 . 0 Acres
m:1 coel\s here\fo rm s\888 5