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iii iiiiiiiiiiiii iii <br />999 <br />STATE, OF COLORADO <br />~ ~•~•^.~~^'~ / Roy Romer, Governor <br />•~~'• <br />DEPARTMENT OF NATURAL RESOURCES ~ ~°'~ <br />MINED LAND RECLAMATION DIVISION "'1 ~_~~~~"~ <br />FpED R. BANTA, olnetar APPLICATION FORM FOR A REVISION _ ~ '~.• ~• r <br />TO A COAL MINING AND RECLAMA710N PERNI7 ~~Y <br />This form must be completed and submitted with all requests for minor revisions, as defined <br />in Rule 1,04(73}. technical revisions as defined in Rule 1.04(36) and permit revisions, as <br />defined in Rule 1.04(90). All revisions are to address the requirements of ?ule 2.08.4. <br />Three copies of 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 replace the <br />revised sections, maps. tables and/or figures. Explain 1n the revision what section is being <br />revised. The revision date should be printed in the lower right corner of the revision <br />pages. If necessary, the Table of Contents should also be revised. when the fi^al version <br />of the revision is approved, 7 copies must be sent to OSl•1 in Denver for Federal mines and `or <br />non-Federal mines 1 copy must be sent to OSM at 625 Silver Avenue, SW, Suite 310, <br />Albuquerque, New Mexico 87102. The revision may not proceed until OSM has been provided <br />copies. Copies should be sent certified mail. <br />Date: / a/ 0 3/ g 3 <br />Permittee: (3 A S i N- R~ S D U D C ~-s ~~ ~;- <br />greet: J !~ 3 D O -/f" / 6 ~ 4J ~Y -7 Z OCT 1 3 199 <br />-- - <br />City: ~~S _O ti-----------L_.,___ .. _. ., <br />State: L O Zip Code: - - - - - - - - - - <br />:4ine Name: ~ ~ C. D ~ tU -~ ~G' /- L- _ ~ r .U E - - - <br />is ox o e t e to y e tvtston: <br />Type of Revision: ~ /2 (PR, TR, or MR) <br />~evision Number: _ _ (Sequential by Revision Type) <br />~ev. Submittal Date _ /- -/- - (Date Received by Division) <br />Rev. Completeness Date: - -/ -/ - Rev. Incompleteness Date: - -/- -/_ - <br />Rev, Adequacy Due Date: - -/- -/ - Rev. Adequacy Date: - -/- -/- _ <br />P,ev. Decision Due Date: - -/ -/ _ Lead Reclamation Specialist: - - - <br />rte escrtp ton o evtston: 5 ~ ~ Q - - - - - E <br />Public Notice Attached - Yes )C -Ro l~qutre~ ~or~R s and'-TR s)- - <br />Bond Increase: Yes !lo ~- -Federal ~ Non-Federal 17ine <br />Proposed Change in: <br />"`"'sturbed Area (+/-) Acres Affected Area (+/_) Acres <br />~~rmit Area (+/-) - _ -,- Acres Federal Land (+/_) - - - - Acres <br />State Land (+/_) - - - - Acres Private Land (+/_) - - - Acres <br />6185E (Rev. 10/88) <br />215 Centennial Building, 13 t 3 Sherman Street Denver, Colorado 80203.2273 Tel. (303) 6663567 <br />