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L <br />Of ~ <br />'~"~~~`,,y$ COLORADO D~ii VISION OF MINERALS AND GEOLOGY <br />••,~"• 1313 Sherman S[r Roo[rs 215, Denver, Colorado 80203, (303) 866-3567 <br />/a'/6 ' <br />RECEI~/~~ <br />APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT OCT 1 4 1991 <br />9Nls+on of Mme[a~o u ~~-•-~. <br />This form must be completed and submitted with all requests for minor revisions, as defined in Rule 1.04(731, <br />technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 1.04(901. All <br />revisions are to address the requirements of Rule 2.08.4. Three 131 copies of the revision, including maps, <br />must be submitted in order for it to be complete. <br />Atl revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, <br />tables and/or figures, with a revised table of contents, if necessary. The revision submittal date should be <br />printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature <br />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 (except OSM) at the same time the application is submitted to the Division, and proof of distribution must <br />be submitted to the Division along with the application. Copies of revision pages modified during the review <br />process must be distributed in the same manner, along with proof of distribution. Proof of distribution must <br />be submitted prior to implementation of the revision. <br />Permit No.: C - 80 - 006 Date: ~_ / ~_ / S~ <br />Permittee: KERR COAL COMPANY <br />Street: 1130 COUNTY ROAD 29A <br />City: uel,ncnl <br />State: CO Zip Code: gpggp - <br />Brief Description of Revision: CHANGES IN TIPPLE RECLAMATION PLAN <br />Public Notice Attached: Yes <br />Bond Increase: Yes _ No ~ <br />Proposed Change~in: <br />Disturbed Area (+`/-1 2 <br />Permit Area ~+(-) _ _ ? <br />State Land (~+/-) _ _ _ <br />No X (Required for PRs and TRsI <br />Federal Non-Federal X Mine <br />5 Acres Affected Area ~+ -1 _ _ 1 <br />5 Acres Federal Land (+/-) _ _ _ <br />Acres Private Land (+ -) _ _ ? <br />~r Acres <br />Acres <br />5 Acres <br />1 <br />