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<br />OF ~ CO< <br />,~F' Q ~A <br />r ,y [~'~ O <br />t cR~-o1/ t <br />* 1876 s <br />Rrcnartl D. Lamm <br />Governor <br />APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />C~ <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 Rul a 2.08, 4, <br />All 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 8 / O 3 / ~8 <br />Permittee: T R A P P E R_ M I N I N ~_ ~~~','~~°~~ <br />I N C _ _ _ _ _ _ _ _ _ _ _ <br />Street: P O B o x I 8 7 pll!'~ )gee <br />- - - - - - - - - - - - - - - <br />--------------- Ib:i_:.:::.!iivU <br />RECLF~;,.ir;7 li:1i~ DIYISIG~v <br />City: c R A ~~_______ <br />State: c o Zip Code: 8 1 6 2 ~ - _ _ _ _ <br />Permit No.: C- 8 1 - 0 1 0 <br />This box to be filled in by the Division: <br />Type of Revision: _ _ (PR, TR, or h1R) <br />Revision Number _ _ (Sequential by Revision Type) <br />Revision Submittal Date _/_/ (Date Received by Division) <br />Pevision Completeness Date _/ / Revision Incompleteness Date _/ / <br />Revision Adequacy Due Date _/ / Revision Adequacy Date _/ / <br />Revision Decision <br />Fee 50.00 <br />Brief Description of Revision: L E A v E_ U_N S A_ L V A G E <br />A B L E T O P S O I L <br />------------------ <br />Public Notice Attached - Yes _ No x (Required for PR's and TR's) <br />Bond Increase: Yes No x <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ 0. _ Acres Affected Area (+/-) _ _ 0_,_ Acres <br />Permit Area (+/-) _ _ 0, _ Acres Federal Land (+/-) _ _ _ Acres <br />State Land (+/-) Acres Private Land (+/-) Acres <br />Lead Reclamation Specialist G R S 6185E <br /> <br />DEPARTMENT OF NATURAL RESOURCES <br />Davitl H. Getcnes Eaecutrve Director <br />MINED LAND RECLAMATION DI1 <br />DAVID C. SNELTON, Director <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />