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<br />STATE O~~RADO <br />DIVISION OF MINERALS AND GEOLOGY OL`T Ov 10t1R <br />nnt,tnmtnl OI NJIUrAI Rffd/KCS 1 IiNV <br />I I U L,e,°u° Si.. Rt"xn 7 i 5 ~~~~~ <br />~^°~" c"'°~•'"" "0~p1 Division of Minerals & Geolo <br />Fnx.i,o,i"+'niii+• APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT ~P~Tn-tFNiOr <br />NATURAL <br />RESOURCES <br />This form must be completed and submitted with ell requests for minor revisions, as defined in Nov Ra.,e. <br />Rule 1.041731, technical revisions, es defined in Rule 1.04(1361, end permit revisions, es defined ciO"""Oi <br />in Rule 1.041901. All revisions are to address the requirements of Rule 2.08.4. Three (31 copies lames Lahhead <br />t~KYlrvf n,rK~a <br />of the revision, including maps, must Ix submitted in order for it to be complete. <br />Mthael a lm~ <br />nn+wn OI,Kiw <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised <br />sections, maps, tables end/or figures, with s revised table of contents, if necessary. The revision submittal <br />date should be printed in the lower right corner of each revision page. A cover letter to the revision should <br />explain the nature at the revision and reference the spedfic permit sections being revised. <br />For federal mines, a copy of the revision epplicetion must be submitted to all agencies on the federal mailing <br />list et 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 [he revision. For non-federal mines, a copy of the epplicetion for which the <br />Division has issued a proposed approval decision must be submitted to the OSM Western Regional <br />Coordinating Center (1999 Broadway Blvd., Suite 3320, Denver, CO 80202-5733), and proof of submittal <br />to OSM must be submitted to the Division prior to implementation of the revision. <br />Permit No.: C - ~ L - ~ 3 a Date: `~_ / 7_ / 9 6 <br />Permittee: E N~ Q nl _ e 0 R L_ C d _ _ <br />- - - - - - - - - - - - - - - <br />-street: ~ O_ DoL-1-1~sS.---- <br />City: ~ Q ~ ~ I ~ ~ - - - - - - - - <br />Stete: S~ Zip Code: ~ ~ ~ ~- L - 1 <br />Brief Description of Revision: LK ~ 1 ~ I~t~{}(L -~~ - f~(aD~ _~Q <br />C'ul~ns -C ~- Esr~c~SH~~.Fv~' <br />~lAJ~4L i11A-~~~ - - - - - - <br />Public Notice Atteehed: Yes <br />Band Increase: Yes _ No <br />Proposed Change in: <br />No _ (Requlrod for PRs end TRsI <br />Federal _ Non-Federal _ Mine <br />Disturbed Aree (+/-(_ _ ~ _ Acres <br />Permit Araa (+l-) _ _ Q . _ Acres <br />State Land (+/-) _ _ Q , _ Acres <br />Affected Area (+/-) _ _ O . _ Acres <br />Federal Land (+/-) _ _ Q . _ Acres <br />Private Land (+/-) _ _ 0 , _ Acres <br />m:looellshere\/orrnate966 <br />