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<br /> <br />STATE OF COLORAIX:~. <br />MINED LAND RECLAMATION DIVISION <br />Depanment a! Wtural Resources <br />t3tJ Sherman Si, Roam 275 <br />Oanver. CO 80203 <br />101 866.1561 <br />Fix: 103 872.8 t 06 <br />~ 117 ~ <br />Nal Rara <br />Gonnv <br />rw 0. flans <br />APPLICATION FORM FOR A REYISION a^~n~ <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for winor <br />revisions, as defined in Rule 1.04(73), technical revisions as defined 1n <br />Rule 1.04(36) and permit revisions, as defined in Rule 1.04(90). All <br />revisions are to address the requirements of Rule 2.08.4, firee (3) copies of <br />your revision including maps must be submitted in order for it to be canplete. <br />A71 revisions are to be formatted so they can be inserted into the permit to <br />replace the revised sections, rttaps, 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 mist be sent to OSM in Denver for Federal mines and for <br />non-federal mines 1 copy oust 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- g 1- 0 3 8 <br />Ddte: 0 6/ 2 9/ 9 2 <br />'•^ q ~, ~ ~ <br />Permittee: CYPRUS ORCHARD VALLEY COAL CORPOR~T ~ ~,. <br />Street: P. O. BOX 1299 - DE~•`'~81992 <br />Brief Description of Revision: SMALL AREA EXEMPTION DEh~ONSTR4TION5 ~ ~ _ - <br />1720 4010 Road _ _ _ _ _ _ _ ,_. ,` <br />City: PAONIA _. _ _ - - - - _ MINErir~Lo «~~_~,,~Y <br />State: CO _ Zip Code: 81428 _ - - - - ^ _ <br />Mine Ndme: CYPRUS ORCHARD VALLEY MINE <br />Public Notice Attached - Yes x No _ (Required for PR's and TR's) <br />bond Increase: Yes No x Federal X Non-Federal Mine <br />Proposed Change 1n: <br />Disturbed Area (+/_) - _ ~,~ Acres <br />Permit Area (+/-) _ , ~,~ Acres <br />State Land (+/_) o Acres <br />Affected Area (+/-) _ _ o,o Acres <br />Federal Land (+/-) _ _ o Acres <br />Private Land (+/_) o Acres <br />6185E (10/90) <br />