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STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Rewurces <br />1313 Sherman 81., Room 215 MR 169 <br />Denier, Colorado 80203 <br />Phone: 13031 866-3 567 <br />Fax:l3o3i e3z~elov APPLICATION FORM FOR A REVISION RFr;FIV <br />TO A COAL MINING AND RECLAMATION PERMIT OCT 19 <br />This form must be completed and submitted with all requests for minor revisiod~y~~tji~p~~ ~, LF~r <br />Rule 1.04{731. technical revisions, as defined in Rule 1.04(36), and permit revisions, as defined cO1Bf1Of <br />in Rule 1 .041901. All revisions are to address the requirements of Rule 2.08.4. Three 131 copies Iamess. 1.«nneae <br />of the revision, including maps, must be submitted in order for it to be complete. Eaecvnve Director <br />Michael B. Long <br />Division Director <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 <br />submittal date should be printed in the lower right corner of each revision page. A cover letter to the <br />revision should 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 Albuquerque Field Office <br />IAFOI, and proof of submittal to AFO must be submitted to the Division prior to implementation of the <br />revision. <br />Permit No.: C- ~ 0- 0 0 9 Date: 1 0/ 1 6/ 9 5 <br />Permittee: Moun.ta.i,n Coa.C Company <br />- - - - - - - - - - - - - - - <br />- - - - - - - - - - - - - - - <br />Street: P•U. Box 591 <br />- - - - - - - - - - - - - - - <br />City: Somehaet <br />- - - - - - - - - - - - - - - <br />State: CU _ Zip Code: ~ 1 4_3_4 _ _ 0 5 9 1_ <br />Brief Description of Revision: Panhi,ng Lo.t Extenh.ian <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 (+/-) _ _ ~ ~ Acres <br />Permit Area (+/-) _ _ 0 0 Acres <br />State Land (+/-) _ _ ~ ~ Acres <br />Affected Area (+/-) _ _ ~ ~ Acres <br />Federal Land (+!-) _ _ ~ ~ Acres <br />Private Land (+/-) _ _ ~ ~ Acres <br />m:lwel\s h arelfo rms\8885 <br />