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STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION of.~o <br />` <br />Department of Natural Resources <br /> <br />1313 Sh <br />R <br />215 <br />S a <br />"~,$ <br />N` <br />~ <br />erman <br />oom <br />t.. <br />Denver <br />CO 60203 ~ ~ .. <br />x <br />. <br />303 866-3567 .•'a ~e •• <br />FAX: 303 632-6706 <br /> Rq~ Rtxnar, <br />Gowrtttx <br /> Fratl R. Banta, <br />APPLICATION FORM FOR A REVISION oMaonu~r <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). A11 <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 must 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- 8 1- 0 1 8 <br />Date: o ~/ i o/ g 6 <br />Permittee: W E_S T E_R N_ F U E L S- U T A H, <br />i r <br />I N C . <br />Street: 4 0 5 U r b a n S t. <br />S~ i t e _~ 0 5,___,___ <br />City: L a k e w o o d `i_________i <br />State: C 0 Zip Code: 8 0 2 2 8- _ _, __ <br />Mine Name; D e s e r a d o M i n e <br />--------------------- <br />Brief Description of Revision: a o A n_ c L A s s I F I__ <br />C A T I O N i <br />Public Notice Attached -Yes x No _ (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 (+/-) _ o o,o Acres Affected Area (+/=} _ _ o .o Acres <br />Permit Area (+/_} o o, o Acres Federal Land (+/-) o Acres <br />. State Land (+/-) _ _ ~ Acres Private Land (+/-) _ _ D Acres <br />._ 6185E (10/90) <br />