Laserfiche WebLink
iii iiiiiiiiuiiiiii <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION of =ate <br />Depattment of Natural Resources ti~ =' 41~ <br />„%~ <br />t3t3 Sherman St.. Room 276 ~;~ ~,~,~ <br />Denver, CO 80203 CL~J'. <br />303 866-3567 7a~e <br />Fn x: 303 832.8706 <br />Roy Romer. <br />Governor <br />' Fretl R. Banta. <br />APPLICATION FORM FOR A REYISION onrision orractor <br />TO A COAL MINING ANO 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. firee (3) copies of <br />your revision including maps must 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 must 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 - ,~ ~ - ~ G s~ ~ <br />Date: D ;~,/ i ~/ 9 ,Z ° 1.,,:.°- <br />Permittee: ~ L / ~ _F ~ .+~ ~ .v C L ,~ c ~i~ ~ 7 ~ L ~. <br />~-` ----------- - NQR1319gp <br />Street: Z ~ ~ 6 E ~ /~ K ,? •y t .1 g ~ v ~, _ . Mlnec ~ <br />~ v ~ - - - _,;~ ana <br />city: Q= ~ ~ ~'=~ ------------- <br />State: ~ D Zip Cad//~e~: ~ ~ 2 3 L, - ? ~ 3 8 <br />Mine Name: ~ if ~~ iL_Q~ r~ ~o ! -------- <br />Bri of Descri pti on of Revision: ~' s-~ ~ ~ L r'" f7 f-` n 1 - F c ,E - <br /> <br />Public Notice Attached - Yes .-----------.-- <br />No _~ (Required for PR's and TR' --.- <br />s) <br />Bond Increase: Yes X No ` Federal Non-Federal }~ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) '-' _ Acres Affected Area (+/-) _ -_- _ _ Acres <br />Permit Area (+/-),7 _~-, - Acres Federal Land (+/-) - i - Acres <br />State Land (+/-) -~ Acres Private Land (+/_) - Acres <br />6185E (10/90) <br />