Laserfiche WebLink
SEP-23-1994 11:11 GRRND URLLEY CORL CO <br />303 858 0344 P.03 <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Deparlmenl of Nawral Rituurces . <br />1 ]t ] $httman St, Room 215 <br />Denver, Colorado 80203 <br />Phpne: (3031 866•)567 <br />FAX: (303) 832-8106 APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />~H <br />B <br />+ <br />NAT RAI <br />~$~~~E:' <br />This form must be completed and submitted with all requests for minor revisions, as defined in aor egmer <br />Rule 1.04031, technical revisions, as defined in Rule 1.04(36), and permit revisions, as defined cw~ <br />in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three 131 copies lanes s. «•.hi,~ad <br />of the revision, including maps, must be submitted in order for it to be complete. taecutive Direcw, <br />Michael fl. len6 <br />Division Di,taa~w <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 <br />submittal date should be printed in the lower right corner of each revision papa. A cover letter to the <br />revision should 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 Albuquerque Feld Office <br />IAFO-, and proof of submittal to AFO must be submitted to tha Division prior to implementation of the <br />revision. <br />Permit No.: C-$ L- O Z a Date: D 9 I Z 3/ 9 <br />~ ~ ~ L - C ~ - - - - - - - - <br />Street: ~Q-~~~_Za------ <br />c'n': G ~~~----------- <br />State: L ~ Zip Code: 8 1 S ~ ~ - ~ Q Z ~ <br />Brief Description of Revision: ~ ~ ~ ,.J,_ 5 ~ - S ~ G = 1 <br />~drl-5~~=s-=--- <br />Public Notice Attached: Yes - No ~ (Required for GRs and TRs/ <br />Bond Increase: Yes _ No ~ Federal x Non-Federal _ Mine <br />Proposed Change in: <br />Disturbed Area (+/•) _ _ d . -Acres <br />Permit Area (+/-) _ _ Q . -Acres <br />State Land (+/-) -• - ~. -Acres <br />Affected Area (+/-) - - O <br />Federal Land (+/-1 - - ~ <br />Private Land (+/-) - - ~, <br />-Acres <br />Acres <br />_ Acres <br />m: \ood\ch svs\forms\8865 <br />