REV101379

• Permit No: C1981014
• IBM Index Class Name: Revision
• Doc Date: 4/15/1992
• Doc Name: APPLICATION FORM FOR A REVISION TO A COAL MINING & RECLAMATION PERMIT
• Type & Sequence: MR19
• Media Type: D
• Archive: No

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STATE OF COLORADO
MINED LAND RECLAMATION DIVISION
Oepanment of Natural Resources
t 3 t 3 Sherman St., Raom 215
Denver. CO 80203
303 866-3567
FAX: [phone]
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Ror Fionw.
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' FrW A. Bang
APPLICATION FORM FOR A REVISION om:ion OireCtGr
TO A COAL MINING AND RECLAMATION PERMIT
This form must be completed and submitted with all requests for minor
revisions, as defined in Rule 1.04(73), technical revisions as defined in
Rule 1.04(36) and permit revisions, as defined in Rule 1.04(90). A11
revisions are to address the requirements of Rule 2.08.4. firee (3) copies of
your revision Including maps must be submitted in order for it to be complete.
A11 revisions are to be formatted so they can be inserted into the permit to
replace the revised sections. maps, tables and/or figures, Explain in the
revision what section is being revised. The revision date shauid be printed
in the lower right corner of the revision pages. If necessary, the Table of
Contents should also be revised. When the final version of the revision is
approved, 7 copies must be sent to OSM in Denver for Federal mines and for
non-Federal mines 1 copy must be sent to OSM at 625 Silver Avenue, SW, Suite
310, Albuquerque, New Mexico 87102. The revision may not proceed until OSM
has been provided copies. Copies should be sent certified mail.
Permit No.: C - _81 - 014_ _
Date: _U4 / 15 _/ ~2_
Permlttee: Energ,~Fuels Coa1~Ir~._ _ _ _ _ _ _
Street: 1190 Coin Road 92 _ _ _ _ _ _ _ _
City: Florence __~_____________
State: CO Zip Code: 81226 _ _ _ - _ _ _
Mine Name: Southfie]d Mine
Brief Description of Revision: Pneum~tjt C.4.dl~r.Y]na-IbstallaYisn ...- .

Public Notice Attached -
Yes - -
X No - - - - - - - - - -
_ (Required for PR's and - - - -
TR's)
Bond Increase: Yes X No Federal Non-Federal .X Mine
Proposed Change in:
Disturbed Area (+/-) _ _ 0 •0 Acres Affected Area (+/-) _ _ ~.~ Acres
Permit Area (+/-) _ _ 0 .0 Acres Federal Land (+/-) _ _ 0 ,p Acres
State Land (+/-) 0 0 Acres Private Land (+/-) 0 .0 Acres
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