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OF'~ <br />t '~ <br />COLORADO DIVISION OF MINERALS AND GEOLOGY <br />•,~~';•• 1313 Sherman St~ ~ Room 215, Denver, Colorado 80203, (303) 866-3567 <br />,e' / III'IIIVIII IIII III <br />999 <br />APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />RECE11/Ep <br />This form must be completed and submitted with all requests for minor revisions, as defined i 1;31, <br />technical revisions, as defined in Rule 1.041136), and permit revisions, as defined in Rule t.04~~ 1~ <br />revisions are to address [he requirements of Rule 2.08.4. Three 131 copies of the revis[glq&~~~ng~fsaps, <br />must be submitted in order for ii to be complete. rl~ g S <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, <br />tables and/or figures, with a revised table of contents, if necessary. The revision submittal date should be <br />printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature <br />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 (except OSM) at the same time the application is submitted to the Division, and proof of distribution must <br />be submitted to the Division along with the application. Copies of revision pages modified during the review <br />process must be distributed in the same manner, along with proof of distribution. Proof of distribution must <br />be submitted prior fo implementation of the revision. <br />Permit No.: C - ~~ - _ 065 Date: _ 02 ~ 19 /~~ <br />Permittee: Nclc FTNANCTAr TN _ <br />COA RTD _F NO r MINE <br />Street: 2768 COMPASS ntxTVF <br />$ T lQl <br />Cfty: S~BAND JUNCTION <br />State; ~Q_ 2ip Code: 81506 - <br />Brief Description of Revision: ci a ; y reci ama ; on ir•r•aa anrlarr3a <br />~s requ; rP~t by st;p~t at; 27 <br />Public Notice Attached: Yes ~ No _ (Required for PR's and TR's) <br />Bond Increase: Yes _ No ~( Federal _ Non-Federal ~ Mine <br />Proposed Change in: <br />Disturbed Area (+/_) _ _ Q,Q gcres Affected Area (+/-) _ _ Q,Q Acres <br />Permit Area (+/_) _ _ Q, Q Acres Federal Land (+/-) _ _ Q, Q Acres <br />State Land (+/_) _ _ Q,Q gcres Private Land (+/-) _ _ Q,Q Acres <br />