REV11527

• Permit No: C1984065
• IBM Index Class Name: Revision
• Doc Date: 8/7/1995
• Doc Name: APPLICATION FORM FOR A REVISION TO A COAL MINING AND RECLAMATION PERMIT
• Type & Sequence: TR12
• Media Type: D
• Archive: No

• • iii iiiiiiiiniu iii
999
STATE OF COLORADO
DIVISION OF MINERALS AND GEOLOGY ~ "'
Depanmenl of Natural Rewurccs .~ ~`\~F V
1717 Sherman 51., Room 215 r~r~
Denver, Colorado 80707 19g5
Phone: [phone] ~ V ~~
FA%: U071 812-81 06 APPLICATION FORM FOR A REVISI~ Geo~o9'1
TO A COAL MINING AND RECLAMATION PERMI~a~s&
This form must be completed and submitted with all requests for minor revisions, as defined in
Rule 1.04(731. technical revisions, as defined in Rule 1.04(36), and permit revisions, as defined
in Rule 1.04(90). All revisions are to address the requirements of Rule 2.08.4. Three (31 copies
of the revision, including maps, mtist be submitted in order for it to be complete.
I~~~~
DEPARTMEM' OF
NATURAL
RESOURCE
Roy Romer
Governor
lames s. Lochhead
Eattulive Direclm
Michael 0. Long
Division Dlrcclor
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 specific permit sections being revised.
For federal mines, a copy of the revision application must be submitted to all 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 Albuquerque Field Office
(AF01, and proof of submittal to AFO must be submitted to the Division prior to implementation of the
revision.
Permit No.: C- 8 4 - 0 6 5 Date: 0 8/ 0 4/ 9 5
Perntittee: N C I G_ F I N A N C I A L i_ I N C________
C O A L_ R I D G E_ N O__ 1_ M I N E______
Streel: 2 7 6 8_ C O M P A S S_ D R I V E__
S U I T E _ 1 0 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
City: G R A N D _ J U N C T I O N _ _ _ _ _ _ _ _ _ _ _ _ _ _
Slale: C O Zip Code: 8 1 5 0 6- __________'____
Brief Description of Revisiolt: A D D R E S S_ P H A S E_ I______
B O N D_ R E L E A S E_ I S S U E S__
Public Notice Attached: Yes xx No _ (Required jor PR's and TR's)
Bottd Increase: Yes _ No XX Federal _ Nolt-Federal XX Mine
Proposed Change in:
Disturbed Area (+/-) _ _ 0.0 Acres Affected Area (+/-) _ _ 0.0 Acres
Permit Area (+/-) _ _ 0.0 Acres Federal Land (+/-) _ _ 0.0 Acres
State Land (+/-) _ _ 0.0 Acres Private Lattd (+/-) _ _ 0.0 Acres