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JRN-29-'93 10:12 ID: CO MINED LRND REC'L TEL N0: 303-832-8106 ti041 P02 <br />STATE OF <br />DIYISION OF MINERALS AND GEOLOGY <br />peparlmanl aF Natural Resources _ <br />1713 Sherman SI., Room 215 ~ ~~' <br />Denver, CO eozo7 ', ; <br />Phom:13071 e66.3567 <br />FA%: (J031 A72-8106 <br />APPLICATION FORM FOR A REVISION cwrtnmer <br />TO A COAL MINING AND RECLAMATION PERMIT C:enmw <br />Mi~hapl B. (uql <br />DNltlon DIRCIOr <br />This form must he completed and submitted Nith all requests for minor <br />revisions, as defined 1n Rule 1.04(73), technical revisions as defined 1n <br />Rule 1.04(136) and permit revisions, as defined in Ruie 1.04(90>. A11 <br />revisions are to address the requirements of Rule 2.06.4. Threo (3) copies of <br />your reviston including maps must be submitted in order for it to be complete. <br />AIt revisions are to be formatted so they can be inserted into the permit to <br />roplace the ravisod sections, maps, tables and/or figures. Explain 1'n the <br />revision -vhat section 1s befog revised. The revision date should be printed <br />1n the ]over right corner of the revision pages. If necessary, the Table of <br />Contents should also be revised. Nhen the final version of the revision is <br />approved, the Federal operation is responsible for providing one Copy to each <br />of the agencies noted on the Federal Agencies Malting List. For non-Federal <br />mines, the operation 1s responsiblo for providing one copy to OSM in <br />Albuquerque <625 sliver Avenue, 5w, Suite 310, New Mexico 87102). The <br />revision may not proceed until OSM has been provided copies. Copies should be <br />sent certified mail. <br />Permit No.: C - ~ ~, - O <br />Date: _ Sl ,.[, y / 9 3 <br />Permittee: !al "`r°_.cb~. CofK l~?~~? - - - - - RECEIVED <br />_ _ -----~--_.- MAY 171993 <br />Street: /3sa /7 ~ _ ~ti_~3 3 SO - - - - <br /> <br />- - - - ,_ - - - - - - - - - - Division of minerals ~ neology <br />Ci'ty: -J~~,v,r1312 ---- ------------ <br />State: ~'~ Zip Code: 8 0 ~oZ - - - ~ - - <br />Mine Name: ~~N,goc~T (ems /~~~ _ _ _ • - _ ^ - - - <br />Brtef Description of Revision: ~3~,s~3 ~,~_~r= ~~=,'^°'3 /'Q-"ON""''d'~ ~°_`."~""'°''°`~ <br />Public Notice Attached.- Yes ~ No ^ (Roqulred for PR's and TR's) - <br />Bond Increase: Yes _ No ,~ Federal ! Non-Federal ~ Mine <br />Proposed Change In: 62/~ <br />Disturbed Area (+/-) - - - - Acres <br />Permit area (+/-> - - - -Acres <br />State Land (+/-) - - - Acres <br />Affected Area (+/-) - - - ~ Acres <br />Federal land (+/-) _ ^ - Acres <br />Private Land (+!-) - - - Acres <br />6185E (01!93) <br />