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r~ STATE OF COLORADO DIVISION OF MINERALS AND GEOLOGY ~.. Dcparlmcnl of Natural Kcsourccs Pt-r~CIVED 1313 Slrcrman 51., Kou~n 215 C I`u~ Dcnvcr, Colorado a020J II Phunc 170)1 a6G-3567 NOV 14 1994 rnx:uoJla3z-aloe APPLICATION FORM FOR A REVISION TO A COAL MINING AND RECLAMATION PERMIT DGPARTMC:NT OF Division a mlulela~a .: ti2o~ogy NATURAL RESOURCE This form must be completed and submitted with all requests for minor revisions, as defined in KoyK°n~cr Rule 7.04(73), technical revisions, as defined in Rule 1.04136), and permit revisions, as defined ~°~~r°°r in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three (31 copies lames s. Lo<hhcad of the revision, including maps, must be submitted in order for it to be complete. r`~`°~i°~ Dirnr°` 6lichac~ B. long Division Director 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. 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 IAFOI, and proof of submittal to AFO must be submitted to the Division prior to implementation of the revision. Permit No.: C- 8 1- 0 2 2 Date: 1 1/ 1 0/ 9 4 Perntittee: S O M E R S E T M I N I N G C O M P A N Y - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Strcct: P 0 B O X 5 3 5 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - City: S 0 M E R S E T _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ State: C O Zip Code: 8 1 4 3 4- - - - - - - - - - - - - - - Bricf Description of Revision: C L A R I F Y_ B E A R_ C R E E K___ R E C L A M A T I 0 N_ P L A N_____ Public Notice Attached: - - Yes XX - - - No _ - - - - - - - - - - - - - - - - (Regfrired jor PR's and TR's) Bond Increase: Yes No XX Fede ral XX Nou-Federal Mine Proposed Change iu: Disturbed Area (+/-) _ _ 0.0 Acres Affected Area (+/-) _ _ 0.0 Acres Permit Area (+/-) _ _ 0.0 Acres Federal Land (+/-) _ _ 0.0 Acres State Laftd (+/-) _ _ 0.0 Acres Private Land (+/-) _ _ 0.0 Acres