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OF ~O<O <br />4` -~`~4~9p DEPARTMENT OF NATURAL RESOURCES <br />.4,~~. <br />t • ~~ ~ DMINED LANDD~RECLAMATION DIVISION <br />X876 s DAVID C. SHELTON, Director <br />RicnarC D. Lamm -~a <br />Governor APPLICATION FORM FOR A REVISION ~,~~ <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor revisions, as <br />defined in Rule 1.04(13), technical revisions as defined in Pule 1,04(36) and permit <br />revisions, as defined in Rule 1.04(90), All revisions are to address the requirements <br />of Rule 2.08.4. <br />A11 revisions are to be formatted so they can be inserted into the permit to replace the <br />revised sections, maps, tables and/or figures. Explain in the revision what section is <br />being revised. The revision date should be printed in the lower right corner of the <br />revision pages. If necessary, the Table of Contents should also be revised. <br />Date: 0 3/ 2 5/ 8 L <br />Permittee: C o l o r a d o ___ ___ ~~~a~d~~~ <br />~~~ J e s t m o r e l a n d_ I n c. ~d '1 <br />street: P - 0 - _ E ,Q ~ _ L ; ~. ~ _ _ (AAR ^ 7 1987 <br />MIN'tJ lr,~,ru <br />(•Ci ty: P a o n i ~ _ _ , _ _ _ , _ _ _ _ {~~p,bdATiO1~ DIVISION <br />State: C 0 Zip Code: g ~ g 2 _.°_ - _ _ _ _ <br />Permit No.: C- 3 3- 0 3 8 <br />This box to be filled in by the Division: <br />Type of Revision: _ _ (PR, TR, or MR) <br />Revision Number _ _ (Sequential by Revision Type) <br />Revision Submittal Date _/_/ (Date Received by Division) <br />P.evision Completeness Date _/ / Revision Incompleteness Date _/ / <br />Revision Adequacy Due Date _/_/ Revision Adequacy Date _/ /_ <br />Revision Decision Due Date / / Fee E0,00 <br />Brief Description of Revision: Technical Revisior, for t`le co^s :ruction of rock slopes <br />& entries.rprj~{j]].s..dLtbe~-cluirtllLalley "line. <br />Public Notice Attached - Yes X No (Required for PR's and TR's) <br />Bond Increase: Yes X No <br />Proposed Change in: <br />Disturbed Area (+/_) _ ` ~,~ Acres <br />• Permit Area (+/-) _ ~ 0.~ Acres <br />State Land (+/-) _ _ Q,0 Acres <br />Lead Reclamation Specialist T A S <br />Affected Area (+/-) _ _ ~.1 Acres <br />Federal Land (+/-) _ _ ~ 0 Acres <br />Private Land (+/-) _ _ ~r,0 Acres <br />6185E <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866.3567 <br />