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I~~'~I'~I'~~"I~'~' DIVISION OF MINERALS AND GEOLOGY Depanmem ai Natural Resources 1313 SlK+rrun St.. Room 2(5 Deaver. Colorado 80203 Phnrx:~30I1866.3567 STATE OF COLORADO fnep 0 61997 Fnx:uo3ta32-etob APPLICATION FORM FOR A REVISION i ~5~..~,,,.,,. TO A COAL MINING AND RECLAMA'F1C}~11`Iy~1~lI~T This form must be completed and submitted with all requests for minor revisions, as defined in Rov Romer Rule 1,041731, technical revisions, as defined in Rule 1.04(138), and permit revisions, as defined ~OMe1"0f in Rule 1.041901. All revisions are to address the requirements of Rule 2.08.4. Three (31 copies e~KV s~ o ~~d of the revision, including maps, must be submitted in order for it to be complete. ,w¢had 8. lone Dirn,m Dinenw 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 speafic permit sections being revised. For federal mines, a copy of the revision application must be submitted to ail agencies on the federal mailing list at the same time 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 be 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- 8 2 - 0 ~ 6 Date: 0 3/ 0 4/ 9 7 Permittee: T W E N T ~ M I ~ ~ _ _ _ _ _ _ C Q~_ ~_ C O M B A N ~__ _ Street: ~ 9 5 1 5 R O U T T_ C O U N T Y R Q A D_ # 2 _L-_-_--- City: Q A IC C R E E K ______ State: C O Zip Code: 8 _Q 4 6 ~ - _ _ _ Brief Description of Revision: LIESKE SUBSTATION UPGRADE AND POWER POLE INSTALLATION Public Notice Attached: Yes X No_ (Required for PRs and TRs) Bond Increase: Yes X No_ Federal X Non-Federal _ Mine Proposed Change in: Disturbed Area (+/-) _ _ 0 2 Acres Affected Area (+/-) _ _ 0 0 Acres Permit Area ~-) 3 2 0 0 Acres Federal Land (+/-) _ _ 0 0 Acres State Land (+/_) _ _ 0 0 Acres Private Land (+l-) _ _ ~ ~ Acres