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iiiiiiiiiiiuiu iii <br />998 <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Depanment o7 Natural Resources <br />7373 Sherman St., Room 215 <br />Denver. CO 80203 <br />303 866.3567 <br />Fnx: 303 832.8706 <br />OF'~~lC <br />ti~i <br />~~~ <br />n <br />.~v <br />~ ra76 ~ <br />Roy Rama. <br />Govruna <br />' FreE R. Banta. <br />APPLICATION FORM FOR A REVISION o~icn oitr_tor <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form mist 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 ],04(36) and permit revisions, as defined in Rule 1.04(90). A71 <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 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 1n 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 7 copy rtust 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- <br />~ 0 1 8 <br />0 8/ 2 <br />Date: 0 / 9 ~ <br />Permittee: a L U E <br />,-~ _ M 0 U_ N T A I N E <br />„ i ~ ~, ~ N. E R G_ <br />..I~ Y <br />I N C <br />i _ _ _ _ _ _ _ _ _ _ <br />Street: 4 0 5 U r b a n S t. <br />S,~ i t e_ 3 0 5 ______ , <br />City: L a k e <br />---- w o <br />-- o <br />- d <br />-- <br />-------- <br />--- <br />- <br />- <br />State: C 0 Zip Code: g 0 2 2 8- ___ _ <br />Mine Name: D e s e r a d o M i n e <br />Brief Description of Revision; __ a i r e r_ _ r e v i e w <br /> r e v i s i o n <br />Public Notice Attached -Yes ~ No ` (Required for PR's and TR' s) <br />Bond Increase: Yes No X Federal x Non-Federal Mine <br /> <br />Proposed Change in: <br />Disturbed Area (+/-) <br />r _ o o Acres Affected Area (+/-) _ o o Acres <br />Permit Area (+/-) _ _ o. o <br />i Acres Federal Land (+/_) _ _ o Acres <br />State Land (+/-) o Acres Private Land (+/_) 0 Acres <br />6185E (10/90) <br />