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<br />999 <br />tree OF~~$1. STATE OF COLORADO <br />Roy Romer, Govei <br />DEPARTMENT OF NATURAL RESOURCES <br />MINED LAND RECLAMATION DIVISION <br />FRED R. BANTA, Director <br />APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor revlsions, as defined <br />in Rule 1.04(73), technical revisions as defined in Rule 1.04(36) and permit revlsions, as <br />defined in Rule 1,04(90). A11 revisions are to address the requirements of Rule 2.08.4. <br />Three copies of 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 replace the <br />revised sections, maps, tables and/or figures. Explain in the revision what sectton is being <br />revised, fie revision date should be printed in the lower right corner of the revision <br />pages. If necessary, the Table of Contents should also be revised. When the final version <br />of the revision is 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 625 Silver Avenue, SW, Suite 310, <br />Albuquerque, New Mexico 87102. The revision mdy not proceed until OSM has been provided <br />copies. Copies should be sent certified mail. <br />Date: d ~o/ / 3 / 8 8 <br />Permittee: nJE W-GAS L~~-_--- ~~~~H~~~ <br />~N~GG'~.-Cod P---- tl~3 <br />street: ~ l 3 Z - ,~ _ - L y,.N ~ ~,~ ~ JUN 13 1988 <br />GL~G~~-ST€_3Za- MIMf=DLAND <br />City• ~ N c- w o o ~ flECLAMA'(ION DIVISIOw <br />State: ~~ Zip Code: ~ ~ L / Z - - - _. - <br />Permlt No,: C - O ~ ~ <br />- fig---- <br />s ox o e a n y a Div s1 on: <br />Type of Revision: ~n(PR, TR, ar MR) <br />Revision Number Q ~-( (Sequential by Revision Type) <br />Revision Submittal Date ~/(3 /8 d(Date Received by Division) <br />Revision Completeness Date (o /I~ /s3 Revision Incompleteness Date -/,/- <br />Revision Adequacy Due Date -/-''22/_ Revision Adequacy Date -/ /- <br />Revision Decision Due Date ~ /~a/8a Fee )i0.s~ <br />Brief Description of Re visio ~ <br />jj_~ ~ y S~ ~Z 1 ~ ~ - C ~- ~ PJ <br /> ~ <br />Public Notice Attached -Yes x--Ao (~qulre3 T'iir~R s and~fR s)- - <br />Bond Increase: Yes No cT federal Non-Federal ~ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) D. Acres Affected Area (+/-) ~ <br />- Acres <br />Permit Area (+/-) - <br />- - ~.- Acres <br />- <br />- Federal Land (+/-) _ ~ _ Acres <br />State Land (+/-) Acres <br />0 Private Land (+/-) O Acres <br />Lead Reclamation Spec~l~t ~~'~ 6185E (Rev. 2788) <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203-2273 Tel. (303) 866.3567 <br />