Laserfiche WebLink
<br />- ~ STATE OF COLORADO. <br />DIVISION OF MINERALS ANp GCfltOGY <br />Department of Matunl Resources <br />t It 3 Sherman A.. Room 2t S <br />Den.er, Cobratb 80201 <br />vnonr uo31866-3562 APPLICATION FORM FOR A REVISION <br />FAX: 003) 832-8706 <br />TO A COAL MINING AND RECLAMATION PERMIT <br />All revisions are to be fortrra[tsd so they an be inserted into the permit to replace the revised <br />sections, maps, tables andlor figures, with a rstrised table of contartts, if necessary. The revision <br />submittal date should be printed in the bvver right co[rter of each revision page. A cover letter to tM <br />revision should explain the nature of the revision and reference the specific permit sections being revised <br />This torn must be completed and submitted with all requests for minor revisions, as defined in ter~~« <br />Rule 7.04(73), technical revisions, as defined in Rule 1-041136), and permit revisions; as defined ~"~ ' ~' <br />in Rule 1.04(901. Alt revisions are to address the requiremertts of Rule 2.08.4. Three I3) coplPa l+~i!sMad <br />of the revision, including maps, must be submitted in order for it to be complete. eeai°"~1eO0r <br />widssel0.la{ <br />' Dwsian 0~emr <br />Go(o/ado Cv~l ~:ne No. l <br />Permit No.: C - $ ~ - Q 'Z ?~, Data: ~ (o / 3 O 1 ~ S <br />Permittee: ~ ~ i 5 ~ r' <br />~ ~ ~ ~ ~ ~' ,~ e 5 <br /> _ ~ <br />l- -1..~- ~~~IF~ <br />street. ~_IZ_ - a ~X. _~3.- -- G~ <br />_ ~~E8011996 <br /> Geo~ogY <br />City: <br />~ ~ e r -~' _ _G e x ~ ~ t- <br />_ ~ ~w~e~a~s ~ <br />_ <br />1S~ooo <br />State: G ~ I~p Code: Z L -- - - - D\v <br />Brief Description of Revision: _C ~ r ~, ~ ~ a f e _ I/ it ~ e <br /> <br />Pubfie Notice Attached: Yes _ No ~ !Required for PRs and TRsI <br />Bond fnerease: Yes _ No ~ Federal _ Non-Federal ~{ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ Q . _ Acres Affected A-ea (+/-) _ _ _~ _ Acres <br />Permit Area (+/-) _ _ ~ . _ Acres Federal Land (+/-) _ _ ~ - _ Acres <br />State Land (+/-) _ _ ~ . _ Acres Private Land l+/-) _ _ ~ _ Acres <br />For federal mines, a copy of the revision appliwtian must be submitted to all agencies On the federal maTing' <br />list at 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 the revision- For non-federal mines, a copy of the applipvan for which the <br />Division has issued a proposed approval decision must be submitted to the OSM Albuquerque Field Office <br />(AFO), and proof of submittal to AFO must be submitted to the Div~ion prior to implementation of the <br />revision <br />m:\eoeRsh ~re5 forma188e S <br />