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STATE OF COLORADO <br />.DIVISION OF MINERALS AND GEOLOGY <br />DeUanmeni o(Natural Resources <br />I S 13 Sherman 51.. Room 215 <br />D C I d 802 3 <br />- ~~;~ <br />°Cr'.EIVED <br />enver, u ora o 0 n ~ ~ ~~"~ <br />Phone: 13031866-7567 Fl~~ O <br />FAX: (3031 832-8106 APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMAT~1vN.o ERM ~®rals & GeDiogy <br />r <br />w <br />II~~~ <br />DEPART-ME[JT OF <br />NATURAL <br />RESOURCES <br />This form must be completed and submitted with all requests for minor revisions, as defined in Ray Romer <br />Rule 1.04173), technical revisions, as defined in Rule 1.04(1361, and permit revisions, as defined cOVef"°` <br />in Rule 1.04(90). All revisions are to address the requirements of Rule 2.08.4. Three (3) copies E eca~sve Dh <eo< <br />of the revision, including maps, must be submitted in order for it to be complete. <br />Michael B Long <br />Division Diream <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised <br />sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal <br />date should be printed in the lower right corner of each revision page. A cover letter to the revision should <br />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 Western Regional <br />Coordinating Center (1999 Broadway Blvd., Suite 3320, Denver, CO 80202-5733), and proof of submittal <br />• to OSM must be submitted to the Division prior to implementation of the revision. <br />Permit No.: <br />Permittee: <br />Street: <br />C_ 9 4_ 0 8 2 Date: 0 8/ 0 9/ 9 6 <br />S E N E C A C 0 A L <br />- - - - - - - - - - - - - - - <br />C 0 M P A N Y _______ <br />1 3 0 0_ S 0 U T H_ Y A L E <br />City: F L A G S T A F F <br />State: A Z Zip Code: 8 6 0 0 1- _ _ _ _ <br />Brief Description of Revision: A D D I T I O N O F L I G H T- U S E <br />R O A D LEAD I N G T O T O P S O I L <br />- - - - - - - - - - - - - - <br />S T O C K P I L E D <br />- - - - - - - - - - - - - - <br />Public Notice Attached: Yes <br />Bond Increase: Yes No x <br />Proposed Change in: <br />• Disturbed Area (+/-) _ <br />Permit Area (+/-) <br />State Land (+/-1 <br />m:\coallshare\forms\6865 <br />No x /Required for PRs and TRsJ <br />Federal R Non-Federal Mine <br />0 0 gcres <br />0 0 Acres <br />0 0 Acres <br />Affected Area (+/-) _ _ 0 0 Acres <br />Federal Land (+/-) _ _ ~ ~ Acres <br />Private Land (+/-) _ _ 0 0 gcres <br />