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III IIIIIIIIIIIIIIII <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />t3t3 Sherman SI.. Room 215 <br />Denver. CO 80203 <br />307 866-3567 <br />FA x: 303 832-8t06 <br />OF COQ <br />,~b _ 9 <br />`'c <br />~e~~~ <br />L r~ <br />~r876 <br />Ray Romer. <br />Govemar <br />Fretl R. Barra. <br />APPLICATION FORM FORA REVISION Division Dire^.or <br />70 A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests far 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 must be sent to OSN in Denver for Federal mines and for <br />non-Federal mines 1 copy mrst be sent to OSM at 525 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- o t 9 <br />Ddte: 0 3/ 1 7/ 9 4 <br />Permittee: c 0 L 0 W Y _0 _ C 0 A L_ C 0 RF~~~~~~ <br />Street: s L3..L.-~s~s~.--__~ N1AR21199¢ <br />H I G H W A Y _, 1, 3____ ...DlVigipO <br />C 1 ty : M E E K E R - Of hllfBrdlc 6 UrutubY <br />$tdte: C p Zip Code 8 1 6 4 1 ___ <br />Mine Name: c o L o w Y o_ _ ___,__ _ _ _ _ _ __ <br />Brief Description of Revision: 1 9 9 4_ D E v E L o P M E N z <br />D R I L L I N G _____ ,_ _ <br />Public Notice Attached -Yes No x (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 (+/-) _ _ _ _ Acres <br />Permit Area (+/-) Acres <br />State Land (+/-) Acres <br />Affected Area (+/-) _ _ _ _ Acres <br />Federal Land (+/-) Acres <br />Private Land (+/-) Acres <br />