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STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />t 313 Sherman St.. Room 2t 5 <br />Denver, CO 60203 <br />303 6663567 <br />Fax: 303 632-6106 <br />OF ~~fp <br />w . r~ <br />~~ ~ <br />.a ~~ )_ '~~ <br />r(~^} <br />ee~~\! <br />~ r8'lfi <br />Roy Romer. <br />Govemar <br />' FreC R. Banta, <br />APPLICATION FOAM FOR A REVISION Division Director <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 must be submitted in order for it to be cofnplete. <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 to printed <br />in the lower right corner of the revision pages. If necessary, the Table of <br />Contents should also be revised. Nhen 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 mint 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- 8 1- 0 4 1 ' <br />Date: 0 2/ 2 6/ 9 2 <br />~~ <br />Permittee: P o w d e r h o r n_ C j11~aV~ <br />1-~ <br /> C o m p a n y l99? <br />Street: P O B o x __ <br />1 4 ___ <br />2 <br />3 0 ~~ ~ <br /> - - - - - - - - - - - - - - - <br />ed --a~ <br /> <br /> <br />City: <br />_ __ <br />P a 1 i s a <br />_ <br />d <br />__ <br />e^ <br />___ r,..,: <br />. <br />- - Min <br />___ _no~~~^'atln^ -- <br />State: C 0 Zip Code: 8 1 5 2 6_ <br />Mine Name: R o a d s i <br />- - - - - - d <br />- e <br />- - ~ C a m e o # I <br />- - - - - - - - - - - <br />Brief Descr iption of Revision: N o r t h_ D e c 1 i n e_ F i <br /> n a <br />- - l C o n t o u r s a n d <br />- - - - - - - - - - - - - - <br /> D r a i n a g e <br />Public Notice Attached -Yes X No _ (Required .°or PR's and TR's) <br />Bond Increase: Yes Na X Federal X Non-Federal Mtne <br />Prroposed Change in: <br />Disturbed Area (+/-) _ _ 0. 0 Acres Affected Area (+/=) 0 ,0 Acres <br />Permit Area (+/-) _ _ 0, 0 Acres Federal Land (+/-) 0 Acres <br />State Land (+J_) 0 Acres Private Land (+/-) 0 Acres <br />6185E (10/90) <br />