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r ' <br />STATE OF _COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ' 11-(~~ ~~/E ~) <br />i <br />Department of Natural Resources <br />131 3 Sherman St., Room 215 l~pR i l+yk~ <br />Denver, Colorado 80203 ~ )q~5 III <br />Phone: (J031866~75h7 ~ <br />FAX: 13031 83 2-81 06 APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATId~1~FYN1Y"Perais a ~euiogr- DEPARTMENT o <br />NATURA] <br />RESOURCE: <br />This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer <br />Rule 1.041731, technical revisions, as defined in Rule 1.04136), and permit revisions, as defined c°verrgr <br />in Rule 1.041901. All revisions are to address the requirements of Rule 2.08.4, Three 131 copies Tames s. L«nhead <br />of the revision, including maps, must be submitted in order for it to be complete. F.ec°ti.R oirect°` <br />Michael B. Long <br />Division Director <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 page. 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 Field Office <br />IAF01, and proof of submittal to AFO must be submitted to the Division prior to implementation of the <br />revision. <br />Permit No.: C- 8 1 - D 1 o Date: 0 4 / 1 0/ 9 5 <br />Permittee: T R A P P <br />- - - - - E R M <br />- - - I N I N G I N C <br />- - - - - - - <br />- - - - - <br />Street: P 0 B O <br />- - - - - - - - <br />X 1 8 <br />- - <br />7 <br />- - - - - - - - <br /> <br />- - - - - - - <br />- - - - - <br />CitY: ~~iLI~- - - <br />-- - <br />- - - - - - - - <br />------- <br />State: C O Zip Code: B 1 6 2 6_- <br />Brief Description of Revision: c U L V E R T S &_ D I T C H E 5 <br /> U P D <br />- - A <br />- T E i H A U L R O A <br />- - - - - - - - - D <br />- - <br /> C E R <br />-- - T <br />- I F I C A T I O N S <br />- - - - - - - - - M A P <br />- - <br />Public Notice Attached: Yes _ No ~ (Required for PRs and TRs) <br />Bond Increase: Yes _ No ~ Federal x Non-Federal _ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ _ _ Acres Affected Area (+/-) _ _ _ _ Acres <br />Permit Area (+/-) _ _ _ _ Acres Federal Land (+/-) _ _ _ _ Acres <br />State Land (+/-) _ _ _ _ Acres Private Land (+/-) _ _ _ _ gcres <br />m: \coel\s h ere\fo rm s\8865 <br />