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iii iiiiiiiiiiiii iii <br />999 <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Oeoanment at Natural Resources <br />t 3t 3 Sherman St.. Room 215 <br />Oenvar. CO 80203 <br />307 666.3567 <br />Fax: 303 632.6106 <br />4~ pF 00~' <br />~;a <br />'~ ri' <br />Roy NOOYr. <br />Gc.~nv <br />' FW R. Banu. <br />APPLICATION FORM FOR A REYISION omawn oor,or <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 nest be submitted in order for it to be complete. <br />All 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 must be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 copy nest 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- e z- 0 5 6 <br />Date: 1 0/ 0 6/ 9 ~, <br />Permittee: T W~ ~{ L Y~ 1 1 .!_ _ C O A L ~~CE/!,'cr, <br />J <br />street: z 9 s i ~_~Q,~SS__=~ ~cr 819g~ <br />c o u N I.~L_Ji.Q~1Z_zz_~ ~~ '°~~~ <br />City: O A K Cg ~,~1L,_____,____c` _, <br />State: C O. Zip Code: ~ y_ ,~ ~ Z - <br />Mine Name: F O I D ~~_LS~E1L_~.LbLE___ <br />Brief Description of Revision: p 0 S T M 1 ,~{, 1 ~ ~ _ J.. g ~ ~ _ <br />u s e <br />---------------- <br /> <br />Pubtic Notice Attached <br />- Yes -- <br />X No ----------- <br />_ (Required for PR's and TR' --- <br />s) <br />Bond Increase: Yes No X Federal X Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/_) _ lA_ ,~ Acres Affected Area (+/-) _ N/A _ _ Acres <br />Permit A.-ea (+/_) _ N/A_ _ Acres Federal Land (+/_) _ N/A _ Acres <br />State Land (+/_) N/A Acres Private Land (+/_) N/A Acres <br />