REV97116

• Permit No: C1981022
• IBM Index Class Name: Revision
• Doc Date: 7/26/1993
• Doc Name: APPLICATION FORM FOR A REVISION TO A COAL MINING AND RECLAMATION PERMIT
• Type & Sequence: TR17
• Media Type: D
• Archive: No

• • . iii iiiiiiiiiiiiiiii
STATE OF COLUKAD~ -
MINED LAND RECLAMATION DIVISION of.~a

Deparimenl of Natural Resources ~
e~ +~es ~

1713 Sncrman Sl.. Room 215 N
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Denver. CO 80203 ~`-Lr~
303 866-7567 ~

Fax: [phone] re~c
My Ibrtwr.
Gauemor
FraA A. Banta.
APPLICATION FORM FOR A REVISION o~~ision onegor
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
Rule 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. Three_ (3) copies of
your revision including maps must be submitted in order for it to be complete.
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. When the final version of the revision is
approved, 7 copies must be sent to OSM in Denver for Federal mines and for
non-Federal mines 1 copy mist be sent to OSM at 625 Silver Avenue, SW, Suite
310, Albuquerque, New Mexico 87102. The revision may not proceed until OSM
has been provided copies. Copies should be sent certified mail.
Permit No.: C - 8 1- 0 2 2
Date: 0 7/2 3/ 9 3
Permittee: S
- O M
- - E R
- - S
- E T M I N I N G
- - - - - - - - - - C O M PAN Y
- - - - - - - - - - - -

Street: -
P - -
O - - -
B - - - - - - - - -
O X 5 3 5 - - - - - - - - - - - - -
r,~.
City: S 0 M E R S E T _ _ _ _ _ _ _ _ _ _ _ JiJ?Fa-r~~ _ _ _
State: C 0 Zip Code: 8 1 4 3 4- __ _________
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Mine Name: S O M E R S E T_&_ S A N B O R N_ C ~ 'LYQ'£5~r,,yo~, __
Brief Description of Revision: A D D R E S S P E R.M I T_____
- - - - - - - - - - - - - -
R E N E W A L I S S U E S
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P R - 0 2
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Public. Notice Attached - Yes _ No XX (Required for PR's and TR's)
Bond Increase: Yes No XX Federal XX Non-Federal Mine
Proposed Change in:
Disturbed Area (+/-) _ _ 0.0 Acres
Permit Area (+/-) _ _ 0.0 Acres
State Land (+/-) _ _ 0 Acres
Affected Area (+/-) _ _ 0.0 Acres
Federal Land (+/-) _ _ 0.0 Acres
Private Land (+/-) _ _ 0 Acres
6185F (10/90)