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COLORADO DIVISION OF MINERALS AND GEOLOGY <br />'. r .' 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />_..e.w...,..-e_._~_......__.._..-..__ ..................... _..,....__..._.._....._...........___...__ _....._........._....._.. _.._..._...._ <br />.-R~CEI~ . <br />APPLICATION FORM FOR A REVISION ppR ~ 7 2003 <br />TO A COAL MINING AND RECLAMATION PERMIT <br />Division of Minerals and Geology <br />This form must be completed and submitted with all requests for minor revisions, as defined in Rule <br />1.04(73), technical revisions, as defined in Rule 1.04(1361, and permit revisions, as defined in Rule t .041901. <br />All revisions are to address the requirements of Rule 2.06.4. Three 131 copies of the revision, including <br />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 replace [he revised sections, <br />maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal date <br />should be printed in the lower right corner of each revision page. A cover letter to the revision should explain <br />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 (except OSM) at the same time the application is submitted to the Division, and proof of distribution must <br />be submitted to the Division along with the application. Copies of revision pages modified during the review <br />process must be distributed in the same manner, along with proof of distribution. Proof of distribution must <br />be submitted prior to implementation of the revision. <br />Permit No.: C - 81 - 013 Date: 4 / 16 / 2003 <br />Permittee• Basin Resources, Inc. <br />Street: <br />City: <br />State: <br />3800 County Road 63.9 <br />Trinidad <br />CO Zip Code: 81082 <br />Brief Description of Revision: <br />Revise Hydrologic Monitoring Plan <br />Public Notice Attached: Yes ~C No _, (Required for PRs and TRs/ <br />Bond Increase: Yes _ No ~ Federal ~ Non-Federal ~, Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ 0 0 Acres <br />Permit Area (+/-) _ - ~ . ~ Acres <br />State Land (+/-) _ _ 0 0 Acres <br />Affected Area (+/-) _ _ 0 0 Acres <br />0 0 <br />Federal Land (+/-) _ _ _ _ Acres <br />Private Land (+/-) _ _ ~ ~ Acres <br />m:lcoallsharelfo rm s\8865 <br />