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STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ri <br />Dcparlmcnt of Natural Hcsourccs ~I <br />I J I } Shcnnan 51.. Kuum 215 pp CC ~ /t~ <br />Dwvcr, Colorado a0207 rl~~ C I tr CD ~ S <br />1'hunr: IJDJ) aLLJ.5L7 ~ d <br />rnx uaJlaJZ-aioh APPLICATION FORM FOR A REVISION ~ 1 4 19~ DEIhItTfv1ENT01•ro <br />TO A COAL MINING AND RECLAMATION PER <br />NATURAL . <br />Division of Minerals & Geology RESOURCE:- <br />Tltis form must be completed and submitted with all requests for minor revisions, as defined in Nuy Hnmcr <br />Rule 1 .041731, technical revisions, as defined in Rule 1.04(36), and permit revisions, as defined cOVC1nOf <br />in Rule 1.04190). All revisions are to address the requirements of Rule 2.08.4. Three 131 copies Tames 5. LochheaJ <br />of the revision, including maps, must be submitted in order for it to be complete. ExCUh~CDif1or <br />Michael R. Long <br />Urvision DIICCIO! <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised <br />sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision <br />submittal date should be printed in the lower right corner of each revision page. A cover letter to the <br />revision should explain the nature of the revision and reference the specific permit sections being revised. <br />For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing <br />list at the same time the application is submitted to the Division, and proof of distribution must be submitted <br />to the Division along with the application. Copies of revision pages modified during the review process must <br />be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted <br />prior to implementation of the revision. For non-federal mines, a copy of the application for which the <br />Division has issued a proposed approval decision must be submitted to the OSM Albuquerque Field Office <br />(AF01, and proof of submittal to AFO must be submitted to the Division prior to implementation of the <br />revision. <br />Permit No.: C - 8 1 - 0 2 2 Date: 1 1/ 1 1/ 9 4 <br />Pcrmittec: S <br />- O M E <br />- - - R S <br />- - E <br />- T <br />- - M I N I N G C O M P A N Y <br />- - - - - - - - - - - - - - - - - - <br /> <br />Strect: - <br />P <br />- - - - <br />0 <br />- - - - - <br />B <br />- - - <br />O <br />- - - <br />X <br />- - - - - - - - - - - - - - - - - - - - <br />5 3 5 <br />- - - - - - - - - - - - - - - - - - - <br />- - - - - - - - - - - - - - - - - - - - - - - - - - - <br />City: S O M E R S E T__ <br />- - - - - - - - - - - - - - - - - - <br />State: C O ZipCodc: 8 1 4 3 4- ______________ <br />Brief Dcscril~tiolt of Revision: R E V I S E_ B= S E A M_ M I N E__ _ <br />P L A N <br />- - - - - - - - - - - - - - - - - - - - - - <br />Public Notice Attached: Yes XX No _ (Required fi7r PR's and TR's) <br />Bond Increase: Yes No XX Federal XX Nou-Federal Mine <br />Proposed Chaugein: <br />Disturbed Area (+/-) _ _ 0.0 Acres <br />Permit Area (+/-) _ _ 0.0 Acres <br />Affected Area (+/-) _ _ 0.0 Acres <br />Federal Land (+/-) _ _ 0.0 Acres <br />State Laltd (+/-) _ _ 0.0 Acres Private Lattd (+/-) _ _ 0.0 Acres <br />