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-- ~_ •~ .. <br />A <br />Dtv!SiON OF.titINERALS AND GEOlOG7 <br />Oeoano-em of Natural Roource3 <br />1717 Sh S R 2t5 <br />STATE ~F COLORADO <br />~. .- -k,.--.~,~. <br />Denier, Colorado 8020] ~ E . r ~.! <br />FgX^IJO7018]2bl~06b' APPLICATION FORM FOR A REVISIONAUG I ,1 <br />TO A COAL MINING AND RECLAMATION PERMIT 1yy~ <br />DiV151on Gi ~',~ii ~,'~WJ a :,,~pwl; <br />This form must be completed and submitted with all requests for minor revisions, as defined in <br />Rule 1.041731, technical revisions, as defined in Rule 1.04(1361, and permit revisions, as defined <br />in Ruie 1.04(901• All revisions are to address the requirements of Rufe 2.08.4. Three (31 copies <br />of the revision, including maps, must be submitted in order far it to be complete. <br />DEP.gRTMFNC C <br />Nt1TURA <br />RESOURCE <br />Roy Romer <br />Ga•error <br />lamn s. L«nhe,d <br />tJeNriK Direttp <br />Michat~ 8. LonS <br />Oivivon D~reuor <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 />t <br />1 <br />v. <br />y: <br />Y. <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 he submitted _. <br />prior to implementation of the revision. For non-federal mines, a copy of [he application for which the <br />Division has issued a proposed approval decision must be submitted to the OSM Albuquerque Field Office <br />(AFO), and proof of submittal to AFO must be submitted to the Division prior to implementation of the <br />revision. <br />Permit No.: C - ~ L - ~, 2 2 Date: Q_ ~._ / ~... ~ / Q, _ 6 - . <br /> <br />1\'L1~1 e s~ I ~. -1 n c .--- <br /> <br />Ciry: ~ __4_ ~ ~ s. ~ ~ ~ - - - - - - - <br />State: C 0 'Zip Code: 8 1 4 ~ 4 -- - - - _._ <br />Brief Description of Revision: yl_ i n e _ F_ a ''c 1'-' i ~-~ e~ s <br /> ~n_ ~~.r_1~ c t i o n -~ <br /> ~~~ 2 L i t i o n ---- <br />Public Notice Attached:.:Yes - No ~{ /Required fog PRs and TRsI- - - <br />r <br />Sond -: Yes X' No Federal ~ Non-Federal "''Mine <br />Decrease ~ - - <br />Proposed Change in: <br />Disturbed Area (+/-) - - _ a . Q Acres Affected Area (+/-) - _ 0 0 Acres <br />Permit Area (+/-) - - 0 . 0 Acres Federal Land (t/-) - - 0 0' Acres <br />State Land (+!-1 - - _Q . 0 Acres Private Land (+/-) - - _d . Q Acres <br />m:\coal\sharalform s\8865 <br />