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<br />~ nm .~ 1-+r' fl>J T'7(lT lli7 A T1r1 <br />~J 1Cy1 J~ Vl' I..VLVi~l'1LJlJ <br />MINED LAND flECLAMATION DIVISION of.~o,~ <br />Department of Natural Resources ti6~~ <br />„~~ ~gi <br />t3t3 Sherman St., Room 275 ~~~~,: <br />Denver, CO 80203 <br />303 866.3567 ~ re re' <br />Fn x: 703 632~6t06 <br />Roy Fwmx. <br />Gonmor <br />' Freo R. Banta. <br />APPLICATION FORM FOR A REVISION Division Diratlor <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests far minor <br />revisions, as defined in Rule 1.04(73), technical revisions as defined in <br />Rule 1.04(36) and permit revisions', as defined in Rule 1.04(90). All <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 in 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 rtust be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 copy must 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- 0 2 2 <br />Date: i i/ 2 5/ 9 2 - - -• -, <br />~ n. h. I <br />Permittee: S O M E R S E T M I N I N G -- <br />~;~t,k; <br />C O M P A N Y-_------ - '~' ~ l9g~ <br />Street: P O B O X 5 3 5 <br />City: S O M E R S E T i---_-i <br />State: C O Zip Code: 8 1 4 3 4____ r <br />Mine Ndme: S O M E R S E T & S A N B O R N <br />Brief Description of Revision: P E R M I T N o N c o A L <br />' W A S T E S T O R A G E <br />Bond Increase: Yes No xX Federal Non-Federal Mine <br />.~~~.g~----- ______ <br />Public Notice Attached -Yes No oat (Required for PR's and TR's) <br />Proposed Change in: <br />Disturbed Area (+/-) o, o Acres <br />Permit Area (+/-) 0 0 Acres <br />State land (+/-) o Acres <br />Affected Area (+/-) <br />Federal Land (+/-) <br />Private Land (+/-) <br />0 o Acres <br />_ _a o Acres <br />o Acres <br />6185E (10/90) <br />