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- i:" <br />STATE O <br />F <br />COLORADO <br />_ <br />_ <br />DIVISION OF MINERALS AND GEOLOGY '~ i4~~~"~,. <br />Depanmem of Nawral Rewurces <br />^r 1 rC _~ ~_ <br />~ <br />pf <br />I Jl l Sherman SI.. Room 215 <br />Denver. Colorado 8020) ryry~~11 <br />I ~ 1'If)~ <br />I <br />Phone: X1011866-3567 . ~ ~Yry <br />FA%:130318)2-8106 APPLICATION FORM FOR A REVISION <br /> <br />TO A COAL MINING AND RECLAMAT(~1N 1~fiDl-MiITBtBia g C;ooioyy _ <br />NA•r-t m A r <br /> RESOURCES <br />This form must be completed and submitted with all requests for minor revisions, as defined in Rov Romer <br />Rule 1.04(731, technical revisions, as defined in Ruie 1.04(1361, and permit revisions, as defined cOYG'"D' <br />in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three 131 copies lames 5. E«hhead <br /> <br />of the revision, including maps, must be submitted in order for it to be complete. Eaecunve Direcmr <br /> Michael B. lOnr; <br /> <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised Dn~ninn Di,ecwr <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 revis ion 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 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 />Permit No.: C - ~ 1 - Q ~ ~ Date: 0 4 / ~ 5 / 9 6 <br />Permittee: Z ~ J~ .~ Z ~ ~L ~ ~ ~ - C_ ~ p_ .~ <br /> C 0 ~? g If- ~ -------- <br />Street: 2 9 5 1 5 - R O U T T -~~- <br /> !i 2 7 <br />City: o A J~- Sr_ ~ ~ ~.~------ <br />State: ~ ~ Zip Code: ~ Q [3 ~ L - - - - - <br />Brief Description of Revision: Pouring Concrete at EMD Fan Facility, Installation of <br />Culverts, and Batch Weigh Washdown Water Drain Line <br />T <br />Public Notice Attached; Yes - No x /Required for PRs and TRsI <br />Bond Increase: Yes x No - Federal x Non-Federal - Mine <br />Proposed Change in: <br />Disturbed Area (+/-) - - 0 0 Acres <br />Permit Area (+/-) - - 0 0 Acres <br />State Land (+/-) - - Q . Q Acres <br />Affected Area (+/-) - <br />Federal Land (+/-) - <br />Private Land (+ /-) - <br />0 0 Acres <br />0 0 Acres <br />0 0 Acres <br />