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_~ -~_ <br />STATE OF COLrOrRADO <br />DIVISION OF MINERALS AND GEOLOGY _ RFC'"IVED <br />Department of Natural Resources ~_ <br />1317 Sherman 51.. Room 215 MR 1 ]4 DEC 0 6 1995 ~~~~ <br />Denver, Colorado 80203 <br />Phnne. 13031 866-3567 <br />FAX: 17031 832-8106 APPLICATION FORM FOR A REVISION pivision of Minerals t4 Ge <br />TO A COAL MINING AND RECLAMATION PERMIT D ARTMEN'T OF <br />NATURAL <br />RESOURCES <br />This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer <br />Rule 1.04173), technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined Governor <br />in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three (31 copies E ecusve D~he<eo< <br />of the revision, including maps, must be submitted in order for it to be complete. <br />Michael B Long <br />Di~~i~inn Dueaur <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised <br />sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal <br />date should be printed in the lower right corner of each revision page. A cover letter to the revision should <br />explain the nature of the revision and reference the specific permit sections being revised. <br />For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing <br />list at the same time the application is submitted to the Division, and proof of distribution must be submitted <br />to the Division along with the application. Copies of revision pages modified during the review process must <br />be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted <br />prior to implementation of the revision. For non-federal mines, a copy of the application for which the <br />Division has issued a proposed approval decision must be submitted to the OSM Western Regional <br />Coordinating Center (1999 Broadway Blvd., Suite 3320, Denver, CO 80202-57331, and proof of submittal <br />to OSM must be submitted to the Division prior to implementation of the revision. <br />Permit No.: C- 8 0- 0 0 7_ Date: 1 1/ 2 9/ 9 5 <br />Permittee: MOUNTAIN COAL COMPANY <br />- - - - - - - - - - - - - - - <br />- - - - - - - - - - - - - - - <br />Street: P.0. Box 591 <br />- - - - - - - - - - - - - - - <br />- - - - - - - - - - - - - - - <br />City: _ Somerset ___________ <br />State: ~O_ Zip Code: 8 1 4 3 4_ _ 0 5 9 1_ <br />Brief Description of Revision: As-built of Parking Lot Extension <br />Public Notice Attached: Yes _ No x (Required for PRs and TRsI <br />Bond Increase: Yes _ No x Federal x- Non-Federal _ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ 0 0 Acres <br />Permit Area (+/-) _ _ ~ ~ Acres <br />State Land (+/-) 0 0 Acres <br />Affected Area (+/-) _ _ ~ 0 Acres <br />Federal Land (+/-) _ _ ~ ~ Acres <br />Private Land (+/-) _ _ ~ ~ Acres <br />m: \coal\share\f orms\8865 <br />