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<br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Depanment of Natural Resources <br />7313 Sherman St., Room 215 <br />Denver, CO 80203 <br />303 86(•3567 <br />FA%: 303 832.8106 <br />oy ~°yo <br />ti~ ~4~ <br />„`i :$ <br />. ~ 8 :;'. <br />~~'"/ <br />,~lM'i4 <br />Roy Ramer, <br />Govumor <br />' Fred R. Banra. <br />APPLICATION FORM FOR A REVISION orviswn oowmr <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all 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). All <br />revisions are to address the requirements of Rule 2.08.4. Three (3) copies of <br />your revision including maps must be submitted in order for it to be complete. <br />A71 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. When the final version of the revision is <br />approved, 7 copies crust be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 copy mist be sent to OSM at 625 Silver Avenue, SW, Suite <br />310, Albuquerque, New Mexico 87102. The revision may not proceed until OSM <br />has been provided copies. Copies should be sent certified mail. <br />Permit No.: C - ~ 1 - ~ ~ ~ <br />Date: „p, ~/ ~...3./ ,3. 1 C1 <br />Permittee: - Sr~P~~l'ip1RE~UBQa66T10N_ - - - ~6vG1~ED <br />Street: -2.Q~gpX,hg---------~pY231991 <br />City: -Mined Land <br />- CRAIG. _. - - - - - - - - - -FleslacAa3io~.Division <br />State: ~ ~ Zip Code: ~~y - - - - - - - - <br />Mine Name: <br />- - - - - - - - - - - - - - - - - - - - <br />Brief Description of Revision: DE,YELQPME~IT~II~,N~,UI~pE~Sj$U~UgErS~pl~, _, - <br />Public Notice Attarlted -Yes X No _ (Required for PR's and TR's) <br />Bond Increase: Yes No X Non-Federal Mine <br />Federal ~ <br /> _ <br />Proposed Change in: <br />Disturbed Area (+/-) - - 0 ,- Acres Affected Area (+/-) - - ~.- Acres <br />Permit Area (+/-) - - 0 .- Acres Federal Land (+/-) - - 4 Acres <br />State Land (+/-) - - 0 Acres Private Land (+/_) - - 0 Acres <br />6185F (10/90) <br />