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III IIIIIIIIIIIIIIII <br />9~ <br />_ STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION oF.~o~ <br />Department of Natural Resources tip' -~ ' ~' <br />Ne~ <br />1313 Sherman St., Roam 275 ~ ~ ~ <br />Denver, CO 60203 ~ • ~ '4 ' <br />303 866.3567 ~ ~' <br />~ ye76 ~ <br />Fn x: 303 8328106 <br />Roy Rmrer, <br />Gomm <br />' FreC R. Banta. <br />APPLICATION FORM FOR A REVISION Ulvision t7iregor <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, maps, tables and/or 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 - $ 1 - 0 ~ 5 REDE'/V~D <br />Date: 0 3/ 2 8/ 9 ~ MqR 31 1984 <br />Permittee: M I N R E Ct_ I N C_______(,.. __ <br />- - - - - - nCfPA(,~er•-r <br />~~, o,. <br />Street: 2 z6 $_~0~1 PAS S_p$~V E~_S T~_~ 0`3 _ <br />- - - - - - - - - - - - - - - - - - - - - - - - - - - - <br />City: G R A N D J U N C T I O N <br />- - - - - - - - - - - - - - - - - - - - - - - - - - - - <br />State: C O Zip Code: 8 1 5 0 6- <br />- - - - - - - - - - - - - - - - - - - <br />Mine Name: N O R a H_ T~ O M~ S Q ~1 _ C R E E K_ M., I N E S__ <br />Brief Description of Revision: g g V~ S E_ S P E C~ E S____ <br />D~ V E$ S~ T ]( _ S T~ N Q A~ D <br />- - - - - - - - - - - - - - - - - - <br />Public Notice Attached - Yes XX No _ (Required for PR's and TR's) <br />Bond Increase: Yes _ No XX Federal XX Non-Federal _ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ 0.0 Acres Affected Area (+/-) _ _ 0.0 Acres <br />Permit Area (+/-) _ _ O.Q Acres Federal Land (+/-) _ _ 0.0 Acres <br />State Land (+/-) _ _ 0 Acres Private Land (+/-) _ _ _ Acres <br />6185F (10/90) <br />