1986-09-19_REVISION - C1981012 ‎(2)‎

• Permit No: C1981012
• IBM Index Class Name: Revision
• Doc Date: 9/19/1986
• Doc Name: APPLICATION FORM
• Type & Sequence: TR7
• Media Type: D
• Archive: No

III IIIIIIIIIIIII III
OF'~O<O
9
New 9~~Rp DEPARTMENT OF NATURAL RESOURCES
y ~ ~ ~ * Davitl H. Getcnes. Executive Director
* ~~°'~ /' MINED LAND RECLAMATION DI\
rg 76 * DAVID C. SHELTO N, Director
gicnartl D. Lamm
Governor APPLICATION FORM FORA REVISION
TO A COAL MINING AND RECLAMATION PERMIT
This form must be completed and submitted with all requests for minor revisions, as
defined in Rule 1.04(73), technical revisions as defined in Pule 1.04(36) and permit
revisions, as defined in Rule 1.04(90). All revisions are to address the requirements
of Rule 2.08.4.
All revisions are to be formatted so they can be inserted into the permit to replace the
revised sections, maps, tables and/or figures. Explain in the revision what section is
being revised. The revision date should be printed in the lower right corner of the
revision pages. If necessary, the Table of Contents should also be revised.
Date: --/ --/ --'~s~y~,q~~:q~~ .n
Perinittee: [~iminq_F~el ComLa3nY------- F '".~'`.'~;`•;~~',"r~~a~
Street: 12055 west second Place SAP 1 9 ~ggo
- - - - - - - - - - - - - - -
P_O. Box 1559 - - - - - - - - - ~~iiVi:U ~.lyiii~ R~ (;j~OYIJ~l~T(~~il
Cn(o. Uspt. oP (delura(!;esourc~~s
City: r.~kev~rL~.---------------
State: C 0 Zip Code: 8 0 2 1 5- 9 9 7 7
Permit No C - ~L - ~/ ~--- ----
This box to be filled in by the Division:
Type of Revision: 1~ (PR, TR, or h1R)
Revision Number ~ (Sequential by Revision Type)
Revision Submittal Date q /~/~{ (Date Received by Division)
Pevision Completeness Date ~/~/~ Revision Incompleteness Date -/ /
Revision Adequacy Due Date _/_/_ Revision Adequacy Date _/_/_
Revision Decision Due Date / 92 /6~ Fee E0.00
Brief Description of Revision: Pond 006 emergency overflow pipe - - -
- - - - - - - - - - - - - - - - -
Public Notice Attached - Yes No x (P,equired for PR's and TR's)
Bond Increase: Yes No x
Proposed Change in: No change in land status
Disturbed Area (+/-) _ _ _ _ Acres Affected Area (+/-) _ _ _ _ Acres
Permit Area (+/-) _ _ _ _ Acres Federal Land (+/_) _ _ _ Acres
State Land (+/-) Acres Private Land (+/_) Acres
Lead Reclamation Specialist - - -
6185E
423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. [phone]