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°. <br />STATE OF COLORADO <br />DlVI510N OF MINERALS AND GEOLOGY <br />Depanmem of Nawral Resources R~I;EIVFp <br />1713 Sherman SI.. Room 215 <br />Denver, Colorado 80207 APR 01 1996 <br />Phone: 17071 866-7567 <br />FA%:1;0}1832-8106 APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECL9~~I~~~g~~{~I~eology <br />This form must be completed and submitted with all requests for minor revisions, as defined in <br />Rule 1.041731, technical revisions, as defined in Rule 1.041361, and permit revisions, as defined <br />in Rule 1 .041901. Atl revisions are to address the requirements of Rule 2.08.4. Three 131 copies <br />of the revision, including maps, must be submitted in order for it to be complete. <br />~~~~ <br />DEPARTMENT Oi <br />NATURAL <br />RESOURCE: <br />Roy Romer <br />Governor <br />lames S. Lochhead <br />Executive Director <br />Michael B. long <br />DlViswn Dirxtw <br />All revisions are to be formatted so they can be insetted into the permit to replace the revised <br />sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision <br />submittal date should be printed in the lower right corner of each revision page. A cover letter to the <br />revision should explain the nature of the revision and reference the specific permit sections being revised. <br />For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing <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 application for which the <br />Division has issued a proposed approval decision must be submitted to the OSM Albuquerque Field Office <br />(AFOI, and proof of submittal to AFO must be submitted to the Division prior to implementation of the <br />revision. <br />Permit No.: C- 8 0- 0 0 7 Date: 0 3/ 2 5 / 9 6 <br />Permittee: MOUNTAIN COAL COMPANY- <br />Street: ~,o~Q}L54L~-_-_--_--_ <br />City: SOMERSET _ _ <br />State: ~ ~ Zip Code: ~14.3b _ _ _ - _ _ _ _ <br />Brief Description of Revision: PERMIT RENEWAL _ _ _ _ _ _ _ _ <br />- - - - - - - - - - - - - - <br />Public Notice Attached: Yes _ No x (Required for PRs and TRsI <br />Bond Increase: Yes x No Federal x Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ ~ . ~ Acres <br />Permit Area (+/-) _ _ ~ ~ Acres <br />State Land (+/-) _ _ 0. 0 Acres <br />Affected Area (+/-) _ _ ~ ~ Acres <br />Federal Land (+/-) _ _ _Q . ~ Acres <br />Private Land (+/-) _ _ 0. 0 Acres <br />m:1co el \sh ere\ fo rm x1886 5 <br />