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STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />1313 Sherman SI., Room 215 <br />Denver. CO 80203 <br />303 866-3567 <br />Fa x: 303 632-8106 <br />OF' Cp~ <br />18 <br />.~~~ /~ <br />a 1476 a <br />Hoy Romal. <br />T R # 6 0 Gavemor <br />Fred R. 6ama. <br />APPLICATION FORM FOR A REVISION O~vision 0treotor <br />TO A COAL MINING 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/or 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 mist be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 copy mist be sent to OSM at 625 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 - ~ ~ - 0_Q~_ <br />Date: 1 2/ 1 6/ 9 1 <br />Permittee: Mogtv~~„ ~~AT, ~nMpn~, _, _ ~ _ _ _ <br />Street: P.O. Box 591 i <br />- - - - - - - - - - - - - - - <br />City: Somerset _i~_~___________ <br />State: ~ p Zip Code: ~ L q~~ ` - ~ ~~ <br />Mine Name: _WEST EIIC M~I~_,________„_ ____ <br />Brief Description of Revision: Stimulation responses tg Tg~,5g, _ ,_ _ <br />Proposed grading and draina e tan. <br /> <br />Public Notice <br />Attached <br />- Yes <br />x No - - <br />_ (Required for PR's and - - - - <br />TR's) <br />Bond Increase: Yes ~ No ~._ Federal x Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/-) p Acres <br />Permit Area (+/-) , a ~_._ Acres <br />State Land (+/-) , 0 Acres <br />Affected Area (+/-) _ _ 0 ._ Acres <br />Federal Land (+/-) 0 Acres <br />Private Land (+/_) _ _ ~ Acres <br />6185E (10/90) <br />