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a <br />4 ~' <br />`' _ COLORADO DYVISION OF MINERALS AND GEOLOGY <br />~•~ 1313 Sherman Stre ,Room 215, Denver, Colorado 80203, (303) 866-3567 <br />RECEIVED <br />APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION P~ll~ 5 X999 <br />Division of iNlnerals 6 Geology <br />This form must be completed and submitted with all requests for minor revisions, as defined in Rule 1.04(731, <br />technical revisions, as defined in Rule 1.0411361, and permit revisions, as defined in Rule 1.04(901. All <br />revisions are to address the requirements of Rule 2.08.4. Three 131 copies of the revision, including maps, <br />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 revised sections, maps, <br />tables and/or figures, with a revised table of contents, if necessary. The revision submittal date should be <br />printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature <br />of the revision and reference the specific permit sections being revised. <br />For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing <br />list (except OSMI at the same time the application is submitted to the Division, and proof of distribution must <br />be submitted to the Division along with the application. Copies of revision pages modified during the review <br />process must be distributed in the same manner, along with proof of distribution. Proof of distribution must <br />be submitted prior to implementation of the revision. <br />Permit No.: C • Bl - D27 Date: ~ / ~~- / ~g-- <br />Permittes: DYRDW MTNTN(, TNf <br />Street: 3737 HIGHWAY 133 <br />P.0. BOX 535 <br />City: ~~IFRSFT <br />State: ~Q_ 2ip Code: R14~4 - <br />Brief Description of Revision: FMFRGFNf.Y Af.TIONS RELATED <br />TO CONTROL OF MINE FIRE <br />Public Notice Attached: Yes _ No ~ (Required for PRs and TRsI <br />Bond Increase: Yes X No _ Federal ~ Non-Federal _ Mins <br />Proposed Change in: <br />Disturbed Arsa (+/-1 _ _ ~ . ~ Acres <br />Permit Arsa 1 +/-) _ _ ~ . ~, Acres <br />Affected Arsa (+/-- _ _ ~ • ~ Acres <br />Federal Land (+/-) _ _ ~ . ~ Acres <br />State Land 1 +/-) _ _ ~ . ~ Acres Private Land 1 +/-) _ _ ~ . ~ Acres <br />