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<br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />7313 Sherman St.. Room 215 <br />Denver, CO 80203 <br />303 866-3567 <br />Fnx: 303 832-8106 <br />nr ~•1-11/F-}J <br />Str' u 5 199E <br />APPLICATION FORM FOR A BfvVlaSd~ONnincr?:5 d t;cuiDgy <br />TO A COAL MINING AND RECLAMATION PERMIT <br />OF ~~r0 <br />~4. 9 <br />ti~ j,0 <br />N <br />'~ <br />X976 <br />FioY saner. <br />Govema <br />FreC R. 8an[a. <br />Division DI[MOr <br />This form must be completed and submitted with all requests for minor <br />revisions, as defined in Rule 1.04(73), technical revisions as defined in <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 [.08.4. Three (3) copies of <br />your revision including maps must be submitted in order for it to be complete. <br />All revisions are to be formatted so they can be inserted into the permit to <br />replace the revised sections, maps, tables and/or figures. Explain in the <br />revision what section 1s 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 must be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 copy must 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- 8 1_ o i 9 <br />Date: o a/ 2 9/ 9 5 <br />Permittee: c o L o w Y o c o a l c o L.P. <br />Street: 5 7 3 1 s t a t e H w y 1 3 <br />- - - - - - - - - - - - - - - <br />- - - - - - - - - - - - - - - <br />city: M e~ k e r _.--~---_.-.---.-- <br />State: ~ ~ Zip Code: ~ 1 ~ y- L - - - - - <br />Mine Name: ~~y.~~YS------------- <br />Brief Description of Revision: ~ i Y. ~ ~ ~ _ i k - w = c e r - <br />a,~,~,~c,_, I _~ 1 `m e _t __ <br /> t ~4. n _.__.--~.--- --- <br />Public Notice A ttached -Yes ~. No - (Required for PR's and TR' s) <br />Bond Increase: Yes No X Federal X Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ o_ _ _ Acres Affected Area (+/=) _ o _ Acres <br />- <br />Permit Area (+/-) _ o_ _ _ Acres Federal Land (+/_) _ o _ Acres <br />State Land (+/-) Acres o <br />Private Land (+/-) Acres <br /> - ~ - - <br />- <br />6185E (10/90) <br />