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111 IIIllllllllll Ill STATE OF COLORADO DIVISION OF MINERALS AND GEOLOGY RECEIVED Depanmenf of rYatural Resources 1373 Sherman St., Room 215 Denver. Colarariu 80203 t~~~ 2 9 1999 Phone: 1307) BF6-356: Fnx:1703) 032.8706 APPLICATION FORM FOR A REVISION TO A GOAL MINING AND RECLAMATION PERIIQldslon of Minerals rs ise~ This farm must be completed and submitted with all requests for minor revisions, as defined in Ra, Romer Rule 1.04(73), technical revisions, as defined in Rule 1.04(138), and permit revisions, as tlefined eo•emor in Rule 7.04190). All revisions are to address the requirements of Rule 2.08.4. Three (3) copies E ecuri~e o acme of the revision, including maps, must be submitted in order for it to be complete. Michael B. Long Di•ision D~r,c~or All revisions ors tv 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, s copy of the revision application must be submitted to etl agencies an the federal mailing fist 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 80202-5733), and proof of submittal to OSM must be submitted to the Division prior to implementation of the revision. Permit No.: C- $ 1- 0 2 8 Date: 0 7/ 2 8/ 9 9 Permittee: C 0 0 R S _ E N E R G Y_ C O M P A N Y____,___ Sheet: ~ ~ ~__ 6 0 X 4 6 7 ___ Gity: G O L D E N State: C 0 Zip Code: 8 0 4 0 2- 0 4 6 7 Brief Description of Revision: ~ ~ g ~ ~ ~ ~ ~ _ ____ Public Notice Attached: Yes Bond Increase: Ves ` No ~ Proposed Change in: Disturbed Area (+/-) _ ~ Permit Area (+/-1 0 State Lend (+/-1 _ _ ~ R A C L A M A T I~ N__, No X /Required for PRs end TRsJ Federal _ Non-Federal ~( Mine _ Acres Affected Area (+/-) _ _ 0 . _ Acres _ Acres Federal land (+/-) _ ~ _ Acres Acres Private Land (+l-1 _ _ 0 , `Acres S OF m:lcoallsharelform s16865