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T STATE OF COLORADO DIVISION OF MINERALS AND GEOLOGY RF(;FIVED Depdrlmenl ni Nd1U r,ll ResOUrCes I )1 J Sherman 51 . Room ? f i MR 172 NOV 2 4 1995 ~~~~ Denver, Culorado 80_'07 I Plhone. i303~ 86fi-3567 FAX: (303183?8106 APPLICATION FORM FOR A REVIS tt TO A COAL MINING AND RECLAMATIO~I~~nerais tf taeology pEPARTMENC of NATURAL RESOURCES This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer Rule 1.04(731, technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined governor in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three (31 copies recur ve Dhe<~o< of the revision, including maps, must be submitted in order for it to be complete. Michael B lonµ Dwu~on O~reuur All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, tables andlor figures, with a revised table of contents, if necessary. The revision submittal date should be printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature of the revision and reference the specific permit sections being revised. For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing list at the same time the application is submitted to the Division, and proof of distribution must be submitted to the Division along with the application. Copies of revision pages modified during the review process must be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted prior to implementation of the revision. For non-federal mines, a copy of the application for which the Division has issued a proposed approval decision must be submitted to the OSM Western Regional Coordinating Center (1999 Broadway Blvd., Suite 3320, Denver, CO 80202-57331, and proof of submittal to OSM must be submitted to the Division prior to implementation of the revision. Permit Na.: C- _~ 0_ 0 0 7 Date: l 1/ 2 0/ 9 5 Permittee: MOl1NTA1N COAL COMPANY - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Street: P. U. Sax 591 - - - - - - - - - - - - - - - City: _Samehse.t_ State: _C~ Zip Code: ~ ~ ~ ,~ ~ - ~ ~ ~ 1 Brief Description of Revision: Addi,ti.on o~ MR 124~~,ezometeJe com~Yeti,ans to Exhi,b.it 12 - - - - Public Notice Attached: Yes _ No x (Required for PRs and TRsI Bondlncrease: Yes No X Proposed Change in: Disturbed Area (+/-) _ 0 Permit Area (+/-) _ _ _0 State Land (+/-) 0 Federal X Non-Federal Mine ~ Acres Affected Area (+/-) _ _ 0 ~ Acres ~ Acres Federal Land (+/-) _ _ ~ ~ Acres ~ Acres Private Land (+/-) _ _ 0 0 Acres m:\co al\share\f arms\8865