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OF CO~ <br />h~-~ 7 <br />F~ <br />DEPARTMENT OF NATURAL RESOURCES <br />~i 8~~4 Di"itl M Getcnra. E.rcun"e Dusnor <br />=,g76. MINED LAND RECLAMATION DI\ <br />DAVID C. SNELTON, Director <br />Rrcn~rtl D Lamm <br />~°"`r"°r APPLICATION FORM FOR A REYISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This forth must be completed and submitted with all requests for minor revisions, as <br />defined in Rule 1.04(73), technical revisions as defined in Rule 1.04(36) and permit <br />revisions, as defined 1n Rule 1.04(90). All revisions are to address the requirements <br />of Rule 2.08.4. <br />All revisions are to be formatted so they can be inserted into the permit to replace the <br />revised sections, maps, tables and/or figures, Explain in the revision what section is ~~ <br />being revised. The revision date should be printed in the lower right corner of the <br />revision pages. If necessary, the Table of Contents should also be revised. <br />Date: 1 2 1 0 9/ 8 8 <br />Permittee: .gy~~-y,L~~~~---- ~,~ <br />~.Qg.~-.~QL P A N Y .~-- !`r_~, "-~.n~--., •'~FK,=~ <br />' .-;1 <br />Street: .'Z? 3.-1i...481~~~-.~? - Lir <br />S U I T E_ 2 0 5 _ <br />City: G R A N D- J U N C T I 0 N--';-• "_-' - ~, <br />State: C 0 Zip Code: 8 1 5 0 6 - _ _ _ `," ~ ~ , <br />Permit No C -•g 1- 0 9 7 - <br />This box to be filled in by the Division: <br />Type of Revision: - - (PR, TR, or MR) <br />Revision Number - - (Sequential by Revision Type) <br />Revision Submittal Date _/_/ (Date Received by Division) <br />Revision Completeness Date -/ /- Revision Incompleteness Date -/-/ <br />Revision Adequacy Due Date -/-/- Revision Adequacy Date -!-/- <br />Revision Decision Due Date / / Fee E0.00 <br />Brief Description of Revision: ~ ~ ~ Q ,y ~ -T R U C x - - - <br />S C A L E A R E A F R O M P E R M I T <br />- - - - - - - - - - - - - - - - - <br />Public Notice Attached -Yes y, No -(Required for PR's and TR's) <br />Bond Increaser Yes _ No ~_ <br />Proposed Change in: <br />Disturbed Area (+/-) _ <br />_ _ Acres Affected Area (+/-) _ <br />- _ _ Acres <br />_ <br />Permit Area {+/_) _ _ 0 , g Acres Federal Land (+/-) <br />- _ Acres <br />State Land (+/_) Acres _ <br />Private Land (+/-) 0.8 Acres <br />Lead Reclamation Specialist ~ ~ ~ 6185E <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) g66-3567 <br />