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~.. <br />`~' <br /> <br />~II II~'I~~I~'~~~ ~II <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />7373 Sherman St.. Roam 275 <br />Denver. CO 60203 <br />303 666-3567 <br />Fn x: 3o3 a32•etos <br />pF' pOy~ <br />R~~ 9Q <br />~c~~C <br />•`~~.• <br />/E 7fi <br />Ray Ramer. <br />Gaverro <br />Frey R. Banra. <br />APPLICATION FORM FOR A REVISION oivrsion oi,ecto, <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must 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 1.04(36) and permit revisions, as defined in Rule 1.04(90). All <br />revisions are to address the requirements of Ruie 2.08.4. Three (3) copies of <br />your revision inC]uding maps must be submitted in order for it to be complete. <br />All revisions are to be formatted sa 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 must 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 - a , - ~ L ~ ~~~~~~~~ <br />Date: t z/ o z/ g t <br />Permittee: C O L O~ g, ~ ,,,Q , Y A M P A _ <br /> C O A L_ C O M P A N Y l~~ ~ 8 )g9' <br />Street: 2 9 5 7 9 R O U T T Mined Land <br /> c o u N T Y ' <br />--------- ___ <br />R O A D z ~ <br />-------- Reclamation Division <br />- <br />City: O A K _ C R E E K _`___ ___ __` <br />State: C O Zip Code: a o u b 7- __ __ <br />Mine Name: MINES 11 z,_ E _ E C K M A N _ ~ g ~~ _, _, <br />Brief Descr iption of Revision: M R 9 1 _z 4 _ _ ` _ _ _ _ _ _ _ _ <br /> M I D T E R M R E S P O N S E~___ <br />Public Notice Attached -Yes _._._ No X (Required far PR's and TR's) <br />Bond Increase: Yes No X Federal X Non-Federal Mine <br />Proposed Change 1n: <br />Disturbed Area (+/-) _ N/A_._ Acres <br />Permit Area (+/-) N/A _ Acres <br />State Land (+/-) _ ~A Acres <br />Affected Area (+/=) _N/A . Acres <br />Federal Land (+/-) i N/A Acres <br />Private Land (+/-) i ~/g Acres <br />