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:.,• . DIVISION OF ~ti11NERAlS AND GEOLOGY Deparlmenl of Natural Rewurces STATE OF COLORADO ~-® 1713 Sherman St., Room 215 R~~EIVED Denver. Colorado 80207 A'' Phone: 17071868-7567 7Wr ~J Fa%:(3031832-8106 APPLICATION FORM FOR A REVISION 19,96 TO A COAL MINING AND RECLAMATION PERMIT DEPNRTMFNI'OF QtbtatdN m wIIFBFaIS d (deal NATURAL ~9Y RESOURCES This form must be completed and submitted with all requests for minor revisions, as defined.in RayROmer Rule 1.041731, technical revisions, as defined in Rule 1.0411361, and permit revisions, as defined ce'~ert'Of in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three 131 copies lames s. Lochhead of the revision, including maps, must be submitted in order for it to be complete. taK°trK o~rea« Michael g. Long Division DIreC~Or All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, tables andlor figures, with a revised table of contents, if necessary. The revision submittal date should be 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 specific 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 Albuquerque Field Office IAFOI, and proof of submittal to AFO must be submitted to the Division prior to implementation of the revision. Permit No.: C - ~ L - ~ 2 2 Date: 0 _ R _ / _2 2 / 9. 6 _ .. Permittee: ~ ~ ~ ~ ~C - ~ E~ s ~ ~ ~ -' $~ 1t'L1 .11 e ~ a 1 ~, - 1 n c.--- _-Street: - ~. ~. - ~F o x - ~" ~ 1 - - _ - - C i t Y ~ _ S_ ~ ~ ~ s . ~ ~ ~. - - - - - - - State: C 0 Zip Code: ~ 1 ~• ~ ~• - - - - - -. _ Brief Description of Revision: R e c 1 a m a .t.. `i ...o. n Y 1 a n R e v i s i o n Public Notice Attached:,:Yes X No - IRequiied for PRs and TRsI - - Bond Increase: Yes No X Federal X Non-Federal Mine Proposed Change in: Disturbed Area (+/-) - - p _ . Q Acres Affected Area (+/-) - _ 0 . 0 Acres Permit Area (+/-) - - ~ . 0 Acres Federal Land (+/-1 - - 0 . Q Acres State Land (+/-) - - _Q. _Q Acres Private Land (+/-) - - _0 , 0 Acres m: \co el\sh ere\ Fo rm s\886 5