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<br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION of ~o~ <br />Department of Natural Resources ~~ ~~ <br />1313 Sherman St.. Room 215 ~ ~ ~^~$ <br />Denver. CO 80203 ''~ <br />303 866-3567 ~ ~ rBic <br />Fn%:303 8:12-8106 <br />Roy Romer. <br />Governor <br />Freo R. Barra. <br />APPLICATION FORM FOR A REVISION Division Dnecror <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This forth 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). 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 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 - ~ L - Q ~ ~ _ _ <br />Date: 1 ~/ ~ 3/ ~~ r. '~~~.Q <br />Permittee: ~~r5- ~ngr-q v- Cbrt~,y~~- - f Nov t 7 1992 <br />- - - - - - - - - - - - - - - <br />--------------- <br />c;tr: ee~1e5_lour~_____ ________ <br />State: ~ Zip Codei ~ Q ~ ~ ~ - - - - <br />Mine Name: ~~e,~Ye~ ~[nr /`1ir1~--------- <br />Bri of Descri ti on of Revi si on:`T _ / ,rr~ <br />--s1~`1.------------- <br />- - - - - - - - - - - - - - - - <br />Public Notice Attached - Yes No ~ (Required for PR's and TR's) <br />Bond Increase: Yes No ~ Federal Non-Federal )C Mine <br />Proposed Change in: - <br />Disturbed Area (+/-) - - ~,- Acres Affected Area (+/=) - - Q,- Acres <br />Permit Area (+/_) - - C7,- Acres Federal Land (+/-) - - ~ Acres <br />State Land (+/-) - - (~ Acres Private Land (+/-) - - ~ Acres <br />6185E (10/90) <br />