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<br /> <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />1313 Sherman St.. Room 215 <br />Denver. CO 80203 <br />303 866-3567 <br />Fa x: 303 832-8106 <br />pF COO <br />,~6 _ 9 <br />„~ l$ <br />.~8~. <br />I. <br />. rg~~ <br />PoY flamer, <br />Governor <br />' Fretl R. 8anra. <br />APPLICATION FORM FOR A REVISION Division Ovector <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor <br />revisions, as defined in Rule 1.04(73), technical revisions as defined in <br />Rule 1.04(36) and permit revisions, as defined in Rule 1.04(90). All <br />revisions are to address the requirements of Rule 2.08.4. Three (3) copies of <br />your revision including maps must be submitted in order for it to be complete. <br />All revisions are to be formatted so they can be inserted into the permit to <br />replace the revised sections, maps, tables and/or figures. Explain in the <br />revision what section is being revised. The revision date should be printed <br />in the lower right corner of the revision pages. If necessary, the Table of <br />Contents should also be revised. When the final version of the revision is <br />approved, 7 copies must be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 copy Est be sent to OSM at 625 Silver Avenue, SW, Suite <br />310, Albuquerque, New Mexico 87102. The revision may not proceed until OSM <br />has been provided copies. Copies should be sent certified mail. <br />Permit No.: C - 8 0 - 0 0 5 <br />Date: 1 2/ 1 0 / 9 2 <br />Permittee: B O E R N <br />ECEI VE® <br />C O A C O M P A N Y R <br />Street: 1 3 0 0 _ S O U T H _ Y A L E ~~~ 1$1992 <br />City: F L A G S T A F F i DIVISION OF <br /> _ pmq~gp~~GEOLOGY <br />State: A Z Zi p Code: 8 6 0 0 1 = i `, <br />Mine Name: S <br />- E N <br />- - E <br />- C A <br />- - <br />- I <br />- I <br />- <br />- <br />- <br />- - - <br />- - - - - - <br />Brief Description of Revision: A D D R E S S _ P E R M I T <br /> R E N E W A L A D E Q U A C Y <br /> I S S U E S <br />Public Notice Attache d - Yes X No _ (Required for PR's and TR's) <br />Bond Increase: Yes No X Federal X Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ 0. 0 Acres <br />Permit Area (+/-) _ _ ~. 0 Acres <br />State Land (+/-) 0 Acres <br />Affected Area (+/-) _ _ 0 .0 Acres <br />Federal Land (+/_) _ _ _ 0 Acres <br />Private land (+/_) 0 Acres <br />6185E (10/90) <br />