REV97661

• Permit No: C1982056
• IBM Index Class Name: Revision
• Doc Date: 6/7/1999
• Doc Name: APPLICATION FORM FOR A REVISION TO A COAL MINING AND RECLAMATION PERMIT
• Type & Sequence: TR33
• Media Type: D
• Archive: No

III IIIIIIIIIIIII III
99
DIVISION OF MINERALS AND GEOLOGY
l3epartmem of Natural Resotuces
1713 Sherman St.. Room 215
Denver. Colorado 8020]
• 0 866.35 7
RECEIVED
Phme. t3 31 6 tuI
FAx:[phone] APPLICATION FORM FOR A REVISId1*~ O 7 X999
TO A COAL MINING AND RECLAMATION PERMIT
Division of Minerals 8 Geology
This form must be completed and submitted with all requests for minor revisions, as defined in Rur Rorer
Rule 1.04(73), technical revisions, as defined in Rule 1.041136), and permit revisions, as defined ~OYO'°r
in Rule 1.04(90). All revisions are to address the requirements of Rule 2.08.4. Three 131 copies l~ ' ~ o~~
of the revision, including maps, must be submitted in order for it to be complete.
Mi[iiad a. Lnnq
Oivnian Oirtcmr
All revisions are to be formatted so they can be inserted irtto the permit to replace the revised
sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal
date should ba printed in the lower right corner of each revision page. A cover letter to the revision should
explain the nature of the revision and reference the spedfic permit sections being revised.
For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing
list at the same time the application is submitted to the Division, and proof of distribution must be submitted
to the Division along with the application. Copies of revision pages modified during the review process must
be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted
prior to implementation of the revision. For non-federal mines, a copy of the application for which the
Division has issued a proposed approval decision must be submitted to the OSM Western Regional
Coordinating Center 11999 Broadway Blvd., Suite 3320, Denver, CO 80202-57331, and proof of submittal
to OSM must be submitted to the Division prior to implementation of the revision.
Permit No.: C - ~ Z - ~ ~. ~i Date: ~ ~ I ~ _ 8 . / ~ _g__
Pennittee: T W E ~~~~~~~_-----
Street: 2 9_ S- ~ ~ - g ~ 1.L L L ~~ JJ ~I s Y
~ Q ~ Q_ - ~ 1 Z
City: ~ A ~ - ~ ~ ~ 1~ K- --
State: ~ Q Zip Code: ~ ~ ~ ~ Z -
Brief Description of Revision: TR 99-~4 - FA XT NSION 2R & ~R r:ATEROAD 11 & 12
DFVFI nPMFNT~ CIIRFACF FA("F M(lfll Flf ATI(1N f. INr'I r1FNTAL
Public Notice Attached: Yes X No- (Required for PRs and TRs)
Bond Increase: Yes _ Nom( Federal Non-Federal -Mine
Proposed Change in:
Disturbed Area (+/_) _ _ 0 . ~ Acres Affected Area (+l-) ~ 1 ~ . ~ Acres
Permit Area (+/_) - - Z , Z Acres Federal Land (+/.) 7 1 8 6 Acres
sTA-r~ of coLorz~o
State Land (+/_) 1 ~ ~ , ~ Acres Private Land (+/_) - ~ ~ , Z Acres