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.---~ <br />STATE, OF COL III IIIIIIIIIIIIIIII <br />C..~iv~v <br />Roy Romer, Governor <br />~~ <br />DEPARTMENT pF NATURAL RESOURCES <br />MINED LAND RECLAMATION DIVISION <br />DAVID C. SHELTON, Dlr~etor <br />APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with aT1 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). A11 <br />revisions are to address the requirements of Rule 2.08.4. <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. <br />Date: 08 / 27 / 87 <br />Permittee: L A -P L A T A- C O A L-C O R P ~6.~L~~ tl ~~ <br />- - - - - - - - - - - - - - - <br />Street: 3 ~ o z c . R .- ~2 0- - - - - - ; r p 11987 <br />--------------- MINHDLAND <br />city: ~ ~ ,~ P F R ,~ ~ - - - - - - - - ,__9€Ca,r•,t~Ap71pN DIVISION <br />State: gyp- Zip Code: ~1~2_f~----- <br />Permit No.: C - ~ L - ~ Z ~ <br />This box to be filled in by the Division: <br />Type of Revision: ./~ ~ (PR, TR, or MR) <br />Revision Number ©1 (Sequential by Revision Type) <br />Revision Submit+~1 Date (~j /pU~7(Date Received by Division ) <br />Revision Completeness Date _/_/_ Revision Incompleteness Date / / <br />Revision Adequacy Due Date _/ /_ Revision Adequacy Date _/_/_- - - <br />Revision Decision Due Date / / Fee E0.00 <br />Brief Description of Revision: R A I N A G EL ~.~-~=, <br />~3 7 R' S a t t ~~ r <br />Public Notice Attached - Yes _ No _~(Required for PR's and TR's) <br />Bond Increase: Yes _ No 1 <br />Proposed Change in: <br />Disturbed Area (+/_) _ _ 0. 0 Acres <br />Permit Area (+/_) - - ~,~ Acres <br />State and (+~-) 0 0 Acres <br />4 3 entennial Bui ding,T3T3'Srfennan Street <br />Lead Reclamation Specialist <br />Affected Area (+/-) _ _ 0, p Acres <br />Federal Land (+/-) - - 0 0 Acres <br />Private Land (+/_) _ _ Acres <br />Denver, Colorado 80203.2273 Tel. (303) 866-3567 <br />6165E <br />~c~~~ <br />