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. ~ <br />STAT~~~F COLORADO <br />DIVISION OF MINERALS AND GEOLOGY R~/,~/{~~D <br />Department of Natural Resources (~, <br />• 1717 Sherman St., Room 215 ~V y f/1 J^ r^l <br />Denver, Colorado 80203 ~ ~ /795 f~I~~ <br />Phone: 13031 866.3567 ~r~.~~~ <br />FA%:13031832-8106 APPLICATION FORM FOR A RIONfOer <br />TO A COAL MINING AND RECLAMATION PERII~I~ ~eoloyy DEPARTMENT OF <br />NATURAL <br />RESOURCES <br />This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer <br />Rule 1.04(731, technical revisions, as defined in Rule 1.04(1361, and permit revisions, as defined cOVef"°` <br />in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three (31 copies E.ecurrve Diheuo~r <br />of the revision, including maps, must be submitted in order for it to be complete. <br />Michael B. long <br />Divi>ion Direuor <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 submittal <br />date should be printed in the lower right corner of each 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 distribution 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 (1999 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 />Permit No.: C- ~, 2- O S 7 Date: 1 1/ 1 4/ 9 5 <br />Permittee: S E N E C A C 0 A L <br />- - - - - - - - - - - - - - - <br />C 0 M P A N Y <br />- - - - - - - - - - - - - - - <br />Street: 1 3 0 0 S 0 U T H Y A L E <br />- - - - - - - - - - - - - - - <br />- - - - - - - - - - - - - - - <br />City: F L A G S T A F F <br />State: A? Zip Code: 8 6 0 0 1 <br />Brief Description of Revision: S T o C K _ T A N K _ <br />D E S I G N <br />Public Notice Attached: Yes _ No x /Required for PRs and TRsI <br />Bond Increase: Yes No x Federal x Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ Q . Q Acres Affected Area (+/-) _ _ 0 . Q Acres <br />Permit Area (+ /-) _ _ 0 0 Acres Federal Land (+ /-) _ _ 0 0 Acres <br />State Land (+/-) _ _ 0 0 Acres Private Land (+/-) ^ _ 0 ~ Acres <br />m: \coal\share\fo rms\8865 <br />