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~: <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources I~~~~ <br />1313 Sherman Sl., Room 215 <br />Denver, Colorado 80203 <br />Phone:13031 866-3567 gppLICATION FORM FOR A REVISION <br />FA%:(]031832-8106 <br />TO A COAL MINING AND RECLAMATION PERMIT DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer <br />Rule 1.04173), technical revisions, as defined in Rule 1.0411361, and permit revisions, as defined ~"1Df <br />in Rule 7.04190). All revisions are to address the requirements of Rule 2.08.4. Three 131 copies lames S. Lochhead <br />of the revision, including maps, must be submitted in order for it to be complete. Esm,sive Director <br /> Michael e. Long <br /> <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised Division Director <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 />(AFO1, 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 1 Date: 1 1/ 1 0/ 9 5 <br />Permittee: T II E P I T T S B U R G & MIDWAY C O A L MINING CO . <br />- - - - - - - - - - - - - - - <br />.~..~ <br />Street: P 0- B 0 X- 1 7 6--- ~_ Pr.nr-,l~rtrp <br />--------------- NfIV 1'1995 <br />City: 0 A K C R E E K <br />- - - - - - - - - - - - - - - <br />State: C 0 Zip Code: $ 0 4 6 7 _ - - - ~ivieio~ ,,, ,,,,,,„,..,,... yealegy <br />Brief Description of Revision: M O F F A LF I N A~ P I T C L O S U R~ P L A N <br />AND POST-MINI NG TOPOGRAPHY <br />- - - - - - - - - - - - - - <br />Public Notice Attached: Yes X No - (Required for PRs and TRsI <br />Bond Increase: Yes - No ~ Federal 1( Non-Federal - Mine <br />Proposed Change in: <br />Disturbed Area (+/-) - = 0 . =Acres <br />Permit Area (+/-) - = 0 . =Acres <br />Affected Area 1 +/-) _ = 0 . =Acres <br />Federal Land 1+/-) - = 0 . =Acres <br />State Land (+/-) - = 0 . =Acres <br />m: \co ells h ere\f orme188 B 5 <br />Private Land (+/-) - _ ~ . =Acres <br /> <br />