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~n O <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION of ~o~ <br />4: =' 4 <br />Department of Natural Resources ~ we~18 <br />1313 Sherman St.. Roam 215 + ,;, ~ n ~ <br />Denver. CO 80203 ~' "ey <br />303 8663567 ~ `.yB7s <br />FA% 303 8328106 <br />Roy Romer, <br />Governor <br />Fred R. Banta. <br />APPLICATION FORM FOR A REVISION olvislon olrM_or <br />TO A COAL MI NI N6 AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor <br />revisions, as defined in Rule 1.04(73), technical revisions as defined in <br />Rule 1.04(36) and permit revisions, as defined in Rule 1.04(90). All <br />revisions are to address the requirements of Rule 2.08.4. Three (3) copies of <br />your revision including maps must be submitted in order for it to be complete. <br />All revisions are to be formatted so they can be inserted into the permit to <br />replace the revised sections, maps, tables and/ar figures. Explain in the <br />revision what section is being revised. The revision date should be printed <br />in the lower right corner of the revision pages. If necessary, the Table of <br />Contents should also be revised. When the final version of the revision is <br />approved, 7 copies must be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 copy must be sent to OSM at 525 Silver Avenue, SW, Suite <br />310, Albuquerque, New Mexico 87102. The revision may not proceed until OSM <br />has been provided copies. Copies should be sent certified mail. <br />Permit No.: C- s 1- 0 1 9 <br />Date: 1 2/ 2 0/ 9 4 <br />Permittee: c o ~QYYQ,_YQ~~___ <br />Street <br />city: <br />State: <br />C O M P A N Y_ Jy, ~,, ____ <br />5 7 3 1 S T A T E _____ <br />H I G H W A Y_ 1 3 ____ <br />~FCEIVED <br />DEC 2 7 1994 <br />;:i ivis lPn ~~ ~~~~nerals 6 Geology <br />M E E K E R ___,________,___ <br />C 0 Zip Code: 8 1 6 4 1 - <br />Mine Name: c o L o w Y o _,____________ <br />Brief Description of Revision: s E D I M E N T _ _ , _ , _ i _ <br />C O N T R O L <br />M E A S U R E S <br />Public Notice Attached -Yes No x (Required for PR's and TR's) <br />Bond Increase: Yes No x federal x Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ _ _ Acres <br />Permit Area (+/-) _ _ _ Acres <br />State Land (+/-) i Acres <br />;IA S= /1 !1/art) <br />Affected Area (+/-) Acres <br />Federal Land (+/-) -_ , -_ i Acres <br />Private Land (+/-) Acres <br />