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<br />pF COQ <br />. ~F; /7C~~,p \ <br />ei -;~;! i'F~ 901 <br />H~ c{ DEPARTMENT OF NATURAL RESOURCES <br />y~~..., ~ 7 y David H. Getcnes Executive Director <br />'x~ s ~ MINED LAND RECLAMATION DI\ <br />~--~-~ DAVID C. SNELTON, Director <br />Ricnartl D. Lamm <br />Govemo` APPLICATION FORM FOR A REYISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor revisions, as <br />defined in Rule 1.04(73), technical revisions as defined in Pule 1,04(36) and permit <br />revisions, as defined in Rule 1.04(90). All revisions are to address the requirements <br />of Rule 2.08.4. <br />A11 revisions are to be formatted so they can be inserted into the permit to replace the <br />revised sections, maps, tables and/or figures. Explain in the revision what section is <br />being revised, The revision date should be printed in the lower right corner of the <br />revision pages. If necessary, the Table of Contents should also be revised, <br />Date: 0 4/ 2 0/ 8 7 <br />Perini ttee: W E S T- E L g - ~ ~ g ~ _ - <br />C O M P A ~~-1,~,~~,--- <br />Street: P ~2~-SAX-x..9.1--- <br />City: >~Q1"L~B..~~S-•------------ <br />State: t ~ Zip Code: 8 1 4 3 4 - - - - - <br />Permit No,: C- 8 0- 0 0 7 <br />This box to be filled in by the Division: <br />Type of Revision: ~ ~(PR, TR, or MR) <br />Revision Number _~ _3 (Sequential by Revision Type) <br />Revision Submittal Date ~/ $ / $'7(Date Received by Division) <br />Pevision Completeness Date ~/a3/ $") Revision Incompleteness Date -/ / <br />Revision Adequacy Due Date ~/~($'~ Revision Adequacy Date -/ /- <br />Revision Decision Due Date (~ /23/g'] Fee 50,00 <br />Brief Description of Revision: R E F fl S ~ - P ~ ~ ~ - ~ Q ~ <br /> E R_ V $$~ A N ~,~- --- -- <br />Public Notice Attached - Yes X No (Required fo r PR's and TR's) <br />Bond Increase: Yes _ No ~_ <br />Proposed Change in: No Change In Average. <br />Disturbed Area (+/-) _ - ~.- Acres Affected Area (+/-) - - 0 . - Acres <br />Permit Area (+/-) _ _ 0 ,_ Acres Federal Land (+/-) _ _ 0 Acres <br />State Land (+/-) 0 Acres Private Land (+/-) 0 Acres <br />Lead Reclamation Specialist 6185E <br />423 Centennial Building, 7313 Sherman Street Denver, Colorado 80203 Tel, (303) 866-3567 <br />