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STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />t 3t3 Sherman St., Room 215 <br />Denver. CO 80203 <br />303 866-356 <br />Fax: 303 832-6t06 <br />pF' ~O~p <br />f•: ~9 <br />Ne iJ~"Ia <br />0 <br />.l`~:r. <br />rv <br />X816 ~ <br />Roy Romer, <br />Govemar <br />Freo R. Barra, <br />APPLICATION FORM FOR A REVISION Division D:re:tor <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). 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 - 8 ~ - ~ ~ L <br />Date: ~ 3/ 1 1/ 3. ~ <br />Permittee: ~~~~.Q~~-~~~J,-s..a.~ECEIVE® <br />Street: 13~~-S~~SJi-~gL,~ ppR151991 <br />City: --------------- Mined Land <br />~ ~- g ~' ~ ~' ~' ~ - - - - - - - rti2'Clanratian~ivision <br />State: ~ L Zip Code: 8.~ ~ ~ L - - - - - <br />Mine Name: S~.~L.~.~.A1.1-=~---------- <br />Brief Description of Revision: J~Y~R0I.OGI_C ~ES1lN~VALUBIIp~I AI1D~-,.~_._. <br />STABILIZATION PLAN FOR DITCH TAHRD-9 <br />Public Notice Attached -Yes X. No _ (Required for PR's arid Tit's) - <br />Bond Increase: Yes No ~_ Federal -~ Non-Federal Mine <br />-~ - <br />Proposed Change in: <br />Disturbed Area (+/-) - - ~,~ Acres <br />Permit Area (+/_) - - ~,~ gcres <br />State Land (+/-) - - ~ Acres <br />6185E (10/90) <br />Affected Area (+/_) _ - ~,~ Acres <br />Federal Land (+/_) - - ~ Acres <br />Private Land (+/_) - - ~ Acres <br />