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~ ~.....~ JRN-29-'93 10:12 ID: CO MINED LAND REC'L TEL IJ0:303-832-8106 n041 P02 <br />, <br /> <br />DIVISION OF MINERAL AND GEOLOGY <br />Department of Natural Resources <br />1713 Stxrman 51., Room 215 <br />Denver, CO 80207 <br />Phono; 13031 D66.JSb7 <br />FAX:(J031832•e106 <br />Cil"Sinn 01 R74iC1aU y l.r,~,~YY <br />of c~oLo <br />APPLICATION FORM FOR A REVISION <br />70 A COAL MINING AND RECLAMATION PERMIT <br /> <br />R.ry Rmncr <br />Covemor <br />Mrchapl e. LmR <br />nwi.e,., nip......, <br />Tots corm must be completed and submitted with all requests Tor minor <br />revisions, as defined in Rule 1.04(73), technical revisions as defined 1n <br />Rule 1.04(13G) and permit revisions, as defined In Rule 1.04(90). All <br />revl5fons are to address the requirements of Rule 2.08.4. Three (3) copies uF <br />your reviston~including maps must be submitted in order for It to be complete. <br />All revisions are to 6e formatted so they can be inserted into the permit to <br />replace the revised sections, maps, tables and/or figures, t:xplain to the <br />revision what section is being revised. The revision date should be printed <br />to the Tower right corner of the revision pages. If necessary, the Table of <br />Contents should also be revised. Hhen the final version of the revision 1s <br />approved, the Federal operation 1s responsible for providing one copy to each <br />of the agencies noted on the Federal Agencies Malitng List. For non-Federal <br />mines, the operation is responsible for providing one copy to OSM in <br />Albuquerque <625 511ver Avenue, 5w, 5u1te 310, New Mexlca 87102). The <br />revision may not proceed until DSM has been provided copies. Copies should be <br />sent certified matt. <br />Permit No.: c - ~ ~' - ~ 7 L <br />Date: _ `~,/ - ~5' / S L <br />Permtttee: ,~~*Re~rs oat fy~ir.vy ,_ - - - - <br />Street: ' _(jso~~l~ Sy_ _ ~u rTl~ 3SD - ~. <br />City: ~iiN//3(-~ _ ---~---'------ ---- <br />5tate: ~ o Zip Code: ,~~oZ - - _, ^ - - <br />Mine Name: „~IwRo~~ ~o~a'i {?(wF - - ! - _ _ _ <br />Brief , <br />Descrlptlon of Revision: ~F~vl~o-/~uc iQoa•L1 f ~rzcrzc_[il-!m ~B"'"~ <br /> m~D CuGLrr3RT STRr7Yt+~- C'RBSSrwL-- <br />% <br /> f~R <br />^JO..-TN- <br />~DrfR ol~ _ <br />~i 1 ._ <br /> _ <br />_ <br />_ <br />Public Notice Attached.- Yes ~ No _ (Required for PR' s and TR's> <br />Bond Increase: Yes , No ~ Federal Hon-Federai,__ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) ~ ! - Acres Affected Area c+/-> _ _~ .! Acres <br />Permit Area (+/-> - O_, - Acres Federal land (+/-) _ O_ Acres <br />. State Land C+/-) - O~ Acres Private Land (+/-> ,~ ~ - Acres <br />6185E (01/93) ' <br />