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iii iiiiiiiiiiii iii DIVISION OF MINERALS AND GEOLOGY Depanmem of Natural Resources Ill l Sherman Sl.. Roam 215 [kYrver. Colorado 8020] PAnne:lle11866-3567 RECEIVED JUL 14 1999 FAX: Uoll e32-slab APPLICATION FORM FOR A REVISI N . TO A COAL MINING AND RECLAMATION 1~`"erals 8 Geology This form must be completed and submitted with all requests for minor revisions, as defined in Ror Gamer Rule 1.04(731, technical revisions, as defined in Rule 1.04(1381, and permit revisions, as defined GO1°10f in Rule 1.04(901, All revisions are to address the requirements of Rule 2.08.4. Three (31 copies ~~o ~~ of the revision, including maps, must be submitted in order for it to ha complete. Michael e. lone Divi+ion Oinxttr All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal date should be printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature of the revision and reference the specific permit sections being revised. For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing list at the same dme the application is submitted to the Division, and proof of distribution must be submitted to the Division along with the application. Copies of revision pages modified during the review process must be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted prior to implementation of the revision. For non-federal mines, a copy of the application for which the Division has issued a proposed approval decision must he submitted to the OSM Western Regional Coordinating Center (1999 Broadway Blvd., Suite 3320, Denver, CO 80202-57331, and proof of submittal to OSM must be submitted to the Division prior to implementation of the revision. Permit No.: C - ~ Z - ~ ~. ~ Date: ~ ~ I y ~ / g 3 Permittee: T W E ~V ~~. ~~~~------ Street: Z 2 5- ~ ~ - g ~-. l.L L L -.C~-U ~I 1 Y ~Q~Q_-~.ZZ-------- City: Qg L-~__B_~Ll~------- State: ~ Q Zip Code: ~ ~. ~ ~ L - - - - - Brief Description of Revision: Drivin4 of Rock Rooms in Northeast Mains for storing rock Public Notice Attached: Yes _ No X (Required for PRs and TRs) Bond Increase: Yes _ Nom Federal Non-Federal -Mine Proposed Change in: Disturbed Area (+/_) - - ~ , -Acres Affected Area (+/_) - - ~ , ~ Acres STATE OF COLORADO Permit Area (+/_~ - - _D_ , -Acres Federal Land (+/_) - - ~ , -Acres State Land (+/_) - _ ~ . -Acres Private Land (+/-) _ - Q . -Acres