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<br />• <br />• <br /> <br />DIVISION OF MINERALS ANO GEOLOGY <br />rJlpanminl of Natural Resources <br />STATE OF <br />1 ] 1 ] Sherman 51.. Room 115 <br />DLYIM!I. ~obrado solo] SEP 2 G 1996 <br />FRgrse: lJO)i 8[,6.1567 <br />r~x. uon eJl~elo6 APPLICATION FORM FOR A REVI ION DIVISI"i, vl= <br />TO A COAL MININQ AND RECLAMATI~hS' ~ L~EO~prv <br />This form must be completed and submitted with all requests for minor revisions, as defined in <br />Rule 1.04173), technical revisions, ss defined in Rule 1.0411381, end permit revisions, as defined <br />in Rule 1.041901. All revisions are to address the requirements of Ruls 2.08.4. Three 131 copies <br />of the revision, including maps, must be submitted in order for it to be complete. <br />Roy Rornlr <br />Go,vrv <br />Nmq 5. LahheM <br />Eaetutne Din!csa <br />Mi~haN B. Long <br />Orvnian D~recror <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised <br />sections, maps, tables andlor figures, with a revised table o} contents, if nseesssry. The revision submittal <br />date should be printed in the lower right corner of esch revision page. A cover letter to the revision should <br />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 disvibution 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 Western Regional <br />Coordinating Center 11999 Broadway Blvd., Suite 3320, Denver, CO 80202-57331, and proof of submittal <br />to OSM must be submitted to the Division prior to implementation of the revision. <br />Permitted; H G C O A L C O M P A N Y <br />Permh No.: C - ~ iL - ~ Q ~ Date: Q . 2 / Z_ ~ ! 2 ~ <br />Street: Q~ ~_ T O {il N_ C E N T E R <br />R O A D <br />- - - - - - - - - - - - - - - <br />City: B- O C A_ R A T O N <br />State: F L Zip Code: 3 3 4 8 6 <br />Brief Deseriptlon of Revision: ~I P D A T E_ O ti N E R__ <br />S H I P I N F O R M A T I <br />- - - - - - - - - - - - - - <br />O N <br />- - - - - - - - - - - - - - <br />• <br />Public Notice Attached: Yes _ Nog (Required /or PRs and TRsI <br />Bond Increase: Yes _ No X Federal _ Non-Federal X Mine <br />Proposed Change in: <br />Disturbed Area 1+/-1 _ _ g . __ Acres <br />Permit Aree (+/-I _ _ ,~ . _ Acres <br />State Land 1+/-) _ _ 0 . _ Acres <br />m:\coai\sharetforms\8866 <br />Affected Area (+/-1 _ _ ~ . _ Acres <br />Federal land (+!-1 _ _ ~ . _ Acres <br />Private Lend (+/-I _ _ ~ . _ Acres <br />