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iii iiiiiiiiiiiu iii <br />99 <br />OF CO( <br />,~~' /~ O'P <br />C -~1Pi214 90 <br />y o DEPARTMENT OF NATURAL RESOURCES <br />* :1 „{o ~~ * Davitl H. Getches. E.ecuhve Duector <br />`~``~~ " MINED LAND RECLAMATION DI\ <br />} /g 76 } DAVID C. SHELTON, Director <br />Richard D. Lamm <br />Governor APPLICATION FORM FORA REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor revisions, as <br />defined in Rule 1.04(73), technical revisions as defined in Pule 1.04(36) and permit <br />revisions, as defined in Rule 1.04(90). All revisions are to address the requirements <br />of Rule 2.08.4. <br />All revisions are to be formatted so they can be inserted into the permit to replace the <br />revised sections, maps, tables and/or figures. Explain in the revision what section is <br />being revised. The revision date should be printed in the lower right corner of the <br />revision pages. If necessary, the Table of Contents should"also be revised. <br />Date: _ / _ / _ <br />Perini ttee: -W~+wning Feel Cort~an~ - - - - - - - <br />- - - - - - - - - - - - - - - <br />Street: -12055 West Second Place - - - - - - <br />-P_O _Box 15596 - - - - <br />c; ty: <br />„'`~. a'• , :.a' :`ter V {i~' i~ <br />s~P >. ~ lsss <br /> <br />-~`~~ - - - - - - - - - - - - =%`"-=- ~'-=~F ~atas~i Rea^arccc <br />State: C 0 Zip Code: 8 0 2 1 5- 9 9 7 7 <br />- - - - - - - - - - - <br />This box to be filled in by the Division: <br />Type of Revision: r~° (PR, TR, or MR) <br />Revision Number Q ~ (Sequential by Revision Type) <br />Revision Submittal Date 9 //5/~G (Date Received by Division) <br />P.evision Completeness Date ~/~/~6 Revision Incompleteness Date -/ / <br />Revision Adequacy Due Date -/ / Revision Adequacy Date -/ / <br />Revision Decision Due Date / / / Fee E0.00 <br />Brief Description of Revision: Designation of roads for specific operations <br />- - - - - - - - - - - - - - - - - <br />Public Notice Attached - Yes No x (P,equired for PR's and TR's) <br />Bond Increase: Yes No x <br />Proposed Change in: No change in land status <br />Disturbed Area (+/-) _ _ _ _ Acres Affected Area (+/_) _ _ _ _ Acres <br />Permit Area (+/-) - - - - Acres Federal Land (+/_) _ _ _ Acres <br />State Land (+/-) Acres Private Land (+/_) Acres <br />Lead Reclamation Specialist 6185E <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />