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STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Aesources <br />1713 Sherman St., Room 215 <br />Denver. CO 80203 <br />303 866-3567 <br />Fq x: 303 8328706 <br />'~ ~, \~A' 1~, ~~ 1 V iii. '....•~ ~~~F~~'P <br />N~~%:+~?.1~ <br />J U L ~ 1 1991 ~~2 ~3.~' <br />ra76 ~ <br />wined Land Roy Ramec <br />Governor <br />Reclamation Division Freo R. Banta. <br />APPLICATION FORM FOR A REVISION D~~islon orte:tor <br />TO A COAL MINING ANO 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), AT1 <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 OSP1 in Denver for Federal mines and for <br />non-Federal mines 1 copy must 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 ma i1, <br />Permit No.: C- 8 4- 0 6 2 <br />Ddte: 0 7 / 3 ~ ~, „L <br />Permittee: C O L O R A D O Y A M P A <br />C O A L_ C O M P A N Y__ <br />Street: 2 9 5 7 9 R O U T T <br />C O U _N T Y_ R O A D_ 2 7 <br />City: O A K_ C R E E K _ _____ ,_„ ___ <br />State: C O Zip Code: a o 4 5 ~-__ _, _ <br />Mine Name: M I N E 3 <br />- - - - <br />- - <br />- <br />Brief Descripti on of Revision: T W O _ N_E W_ M O N I T O R I I~„~ _ <br /> WELLS _ F_I E L D <br />a- A P P R OY g,L„_ _ <br /> M R 9 1-7 1 <br />Public Notice A ttached -Yes No x (Required for PR's a nd TR's) <br />Bond Increase: Yes x No Federal Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/_) _ _ o . o Acres Affected Area (+/-) _ _ o . o Acres <br />Permit Area (+/-) _ _ o, o Acres Federal Land (+/-) _ _ o Acres <br />State Land (+/-) _ _ p Acres Private Land (+/-) _ _ Q Acres . <br />~,nm nmm~~ <br />