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STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />OF'~~fp <br />Department of Natural Resources ti~4~ <br />~T~ 1$ <br />1313 Sherman St.. Room 215 <br />Denver, CO 80203 ~ <br />303 866.3567 ~ •~~~~~ <br />FAX: 303 832-8106 ~ re ~e <br />Rq' Ronac <br />Gwmro <br />FreE R. Banta. <br />APPLICATION FORM FOR A REYISION D~~~+on Dirr_Irar <br />TO A COAL MINING AND RECLAMATION PERMIT <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 2.08.4. 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, rteps, tables and/ar 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 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 ~, - 0 2 2 <br />Date: 0 ~/3, 8/ Q 4 <br />Permittee: S O M E R S E T M I N I N G C O M P A N Y <br />- - - - - - - - - - - - - - - - - - - - - - - - - - - - <br />- - - - - - - - - - - - - - - -~?~ 1/fin - - - - - - - <br />Street: g_0__ B 0 X_ 5 3 5 ________________ <br />--------------- MAY-~19g¢------- <br />City: S O M E R S E T _ _ _ _ _ _ _ _ _ _ _ _ _ - - - <br />-~eX~n u1;~~nre,,,, <br />State: C O Zip Code: 8 1 4 3 4 - _ _ _ _ ,.~ <br />~~nlr------ <br />Mine Name: S O M E R S$ a_ &_~~ N$ 0$ N_ C R E E K____ <br />Brief Description of Revision: ~ D D _ E ~ S ~ _ Y ~ $ D _ _ _ _ _ <br />$ E C~ A I M_ dr _ R E V I S E__ <br />A C C E S S_ R 0 A D_ L A Y 0 U T <br />Public Notice Attached - Yes XX No _ (Required for PR's and TR's) <br />Bond Increase: Yes _ No XX Federal CLX Non-Federal _ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ 0.0 Acres Affected Area (+/-) _ _ 0.0 Acres <br />Permit Area (+/-) _ _ 0.0 Acres Federal Land (+/-) _ _ 0.0 Acres <br />State Land (+/-) _ _ 0 Acres Private Land (+/-) _ _ 0 Acres <br />6185F (10/90) <br />