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STATE <br />~IVISION OF MINERALS AND GEOLOGY ~1 Q C ~~pp ~I <br />epanmem of Natural Resources U JU <br />1 313 Sherman St., Room 215 ~ I+d~~ <br />Denver, Colorado 80203 DIVI>l100 Of i1QIrlQfc`)15 & Liauio II <br />Phnne: 13031 tl66-}567 ~ <br />FAX. 13031 832-8106 APPLICATION FORM FOR A REVISION ~ DEPARTMENT OF <br />TO A COAL MINING AND RECLAMATION PERMIT NATURAL. <br />RESOURCES <br />This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer <br />Rule 7.041731, technical revisions, as defined in Rule 1.04(1361, and permit revisions, as defined c°Vef"°` <br />in Rule 1.041901. All revisions are to address the requirements of Rule 2.08.4. Three (31 copies Exe<uts"e D„'e~eod <br />of the revision, including maps, must be submitted in order for it to be complete. <br />Michael B. Lon4 <br />Divn~on Dvecmr <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 submittal <br />date should be printed in the lower right corner of each revision page. A cover letter to the revision should <br />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 Western Regional <br />Coordinating Center (1999 Broadway Blvd., Suite 3320, Denver, CO 80202-57331, and proof of submittal <br />•to OSM must be submitted to the Division prior to implementation of the revision. <br />Permit No.: C- 9 4- 0 8 2 Date: 0 5/ 0 3/ 9 6 <br />Permittee: S E N E C A_ C 0 A L <br />C 0 M P A N Y <br />- - - - - - - - - - - - - - - <br />Street: 1 3 0 0 _ S 0 U T H_ Y A L E <br />- - - - - - - - - - - - - - - <br />City: F L A G S T A F F <br />State: A Z Zip Code: 8 6 0 0 1-____ <br />Brief Description of Revision: A D D I T ION O F H A U L ROAD <br />C U L V E R T Y A- 4 A <br />- - - - - - - - - - - - - - <br />Public Notice Attached: Yes _ No x (Required for PRs and TRs/ <br />Bond Increase: Yes No R Federal X Non-Federal Mine <br />Proposed Change in: <br />.Disturbed Area (+/-) _ _ 0 0 Acres Affected Area (+/-) _ _ 0 0 Acres <br />Permit Area (+/-) _ _ ~ ~ Acres Federal Land (+/-) _ _ ~ ~ Acres <br />State Land (+/-) _ _ ~ ~ Acres Private Land I+/-) _ _ ~ ~ Acres <br />m: \coal\sharelf o rms\8865 <br />