REV09378

• Permit No: C1981013
• IBM Index Class Name: Revision
• Doc Date: 9/28/1992
• Doc Name: Application form
• From: BASIN RESOURCES INC
• To: MLR
• Type & Sequence: MR34
• Media Type: D
• Archive: No

STATE OF COLORADO
___~ r;^ ~ ~ r~• Roy Romer. Governor ~ ;
• re~e'
' li
DEPARTMENT OF NATURAL RESOURCES ~~
MINED LAND RECLAMATION DIVISION ~~~~~'"~
FRED R. BANTA, Dlnetor ~ ~• ~ ' ~ '
APPLICATION FORM FORA REVISION '_`-
TO A COAL MINING AND RECLAMATION PERMIT ~~ ~%
This form must be completed and submitted with all requests for minor revisions, as defined
in Rule 1,04(73), technical revisions as defined in Pule 1,04f36) and permit revisions, as
defined in Rule 1,04(90), All revisions are to address the requirements of Rule 2.08.4,
Three copies of your revision including maps must be submitted in order for it to be complete.
All revisions are to be formatted so they can be inserted into the permit to replace the
revised sections, maps, tables and/or figures. Explain in the revision what section is beinc
revised. The revision date should be printed in the lower right corner of the revision
pages. If necessary, the Table of Contents should also be revised. 'Ahen the final v~r;ion
of the revision is approved, 7 copies must be sent to OSF1 in Denver for Federal mines and `~r
non-Federal mines 1 copy must be sent to OSId at 625 Silver Avenue, SW, Suite 310,
Albuquerque, New Mexico 87102. The revision may not proceed until OSM has been provided
copies. Copies should be sent certified mail,
Date: D 2/ ~ ~/ ~ Z
Permittee:~/ ~ ~ ~ L ~ <?" - L U ~ ~- _ _ R~~EIVr -
-------
' ,tree t: L~3p p -----__--- SEP281992
City: ~€~~p L,/-------_--- Iv11NERALSBUE~_._~
State: ~ U Zip Code: ~ ~ U ~ l - - - - -
PermitHo,: C -~~ - O L--3
14ine Name: ~r D Lc 12 ~L - r~ ~ ~' ~~- - . - -. - - -
~ rs ox o e i e in y e tvtston:
Type of Revision: ~ ~ (PR, TR, or MR)
Revision plumber: ~ Y (Sequential by Revision Type)
Rev, Submittal Date: _ _/_ _/_ _ (Date Received by Division)
Rev, Completeness Date: _ _/ /_ _ Rev. Incompleteness Date: _ /_ _/_ _
Rev, Adequacy Due Date: _ _/^ -/_ _ Rev, Adequacy Date: _ /_ _^/ _
Rev, Decision Due Date: _ _/- -/_ _ Lead Reclamation Specialist: _ -_ _
rie escrip ion o evis~on: ~ ~ ~ _ ~ L ~~ ~ ~ ~ ~ - -
G
Public pJotice Attached -Yes o KK ~~ equire or~R s and R s)
Dond Increase: Yes rC J!o ~deral tiC Non-Federal h±ine
proposed Change in:
sturbed Area (+/-) U . Acres Affected Area (+/-) Acres
rermit Area (+/-) - ` ~,= gcres Federal Land (+/-) - - - - Acres
State Land (+/_) -_ _ _ Acres Private Land (+/-) -_ - -_ Acres
6185E (Rev. 10/88)
215 Centennial Building, 7373 Sherman Street Denver, Colorado 80203-2273 Tel. [phone]