1986-09-19_REVISION - C1981012 ‎(3)‎

• Permit No: C1981012
• IBM Index Class Name: Revision
• Doc Date: 9/19/1986
• Doc Name: APPLICATION FORM
• Type & Sequence: TR8
• Media Type: D
• Archive: No

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He ""VVlliQr o DEPARTMENT OF NATURAL RESOURCES
~~~ * Davitl H. Gelches. E:ecutrve Director
`.,876.' MINED LAND RECLAMATION DI\
DAVID C. SHELTO N, Director
Ricnartl D. Lamm
Governor APPLICATION FORM FORA REVISION
TO A COAL MINING AND RECLAMATION PERMIT
This form must be completed and submitted with all requests for minor revisions, as
defined in Rule 1.04(73), technical revisions as defined in P.u1e 1.04(36) and permit
revisions, as defined in Rule 1.04(90). All revisions are to address the requirements
of Rule 2.08.4.
All revisions are to be formatted so they can be inserted into the permit to replace the
revised sections, maps, tables and/or figures. Explain in the revision what section is
being revised. The revision date should be printed in the lower right corner of the
revision pages. If necessary, the Table of Contents should also be revised. €~.
Date: --/--/-- ;~c~~~-~.~,'~;; ~;~~3
Perini ttee: W~~mincLF~el Com~an~ - - - - - - -
--------------- SAP 19 19€i~;
Street: 12055 West Second Place
P.o. Box 15596 r•~„r~
- - - - - - - - - - - - - - - l;0!U. ilepi. of ~11Lb!rP.1 .~e_r'~r:,~
Ci tY ~ Lalceca~od
- - - - - - - - - - - - - - - - - - - -
State: ~~ Zip Code: 8 0 2 1 5- 9 9 7 7
Permit No.: C - ~L - OL ~
This box to be filled in by the Division:
Type of Revision: ~~ (PR, TR, or MR)
Revision Number p ~ (Sequential by Revision Type)
Revision Submittal Date ~/~y /,q; (Date Received by Division)
P.evision Completeness Date ~/~/~y
Revision Adequacy Due Date / /
Revision Decisi
Revision Incompleteness Date -/ /
Revision Adequacy Date / /
Fee 50.00
Brief DeSCription of Revision: Utilization of topsoil from borrow area near
non-coal dis~sal area - _ _ _ _ _ _ _ _
Public Notice A ttached - Yes _ No x (Required for PR's and 7R's)
Bond Increase: Yes _ No x
Proposed Change in: Section 2.05.4(5) Topsoil salvaging
Disturbed Area (+/-) - - 2 5 Acres Affected Area (+/_) - - - - Acres
Permit Area (+/-) - - - - Acres Federal Land (+/_) _ _ _ Acres
State Land (+/-) Acres Private Land (+/-) 2. 5 Acres
Lead Reclamatio n Specialist 6185E
423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. [phone]