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,t,: <br />COLORADO DYVISION OF MATER1~.yS A.I~TD GEOLOGY <br />h~~~F <br />.,e~b. 1313 Sherman Sneer, Room 215, Denver, Colozado 802G3, {303) 866-3567 <br />RECEIVED <br />APPLICATION FORM FOR A REVISION OCT 14 1002 <br />TO A COAL MINING AND RECLAMATION PERI$~T . <br />vision at Minerals and Geology <br />This form muse be completed and submitted with all requests for minor revisions, as defined in Rule '1.04173), <br />technical revisions, as defined in Rule 1.04f136), 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 the revision, including maps, <br />must be submitted in order for it to be complete. <br />All revisions are to be #ormatted so they can be inserted iniothe permit to replace the revised sections, maps, <br />tables and/or figures, with a revised table of contents, if necessary. The revision submittal daze should be <br />printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature <br />of the revision and reference the specifiic permit sections being revised. <br />For #ederal mines, a copy of the revision application must be submitted to all agencies on the federal mailing <br />tisi {except OSM) at the same time the application is submitted to the Division, and proof of distribution muse <br />be submitted to the Division along with the application Copies of revision pages modified during the review <br />process must be distributed in the same manner, along with proof of distribution. Proof of distribution must <br />be submitted prior to implementation of the revision. <br />Permit No.: C - $ ~ - $~ ~ Date: ~~ / OZ~ / ~~ <br />Permittee: eSU ~ ~A-t~ Jy /6Ril+Jin16 ~zflRAa3 R„ATe~}I~ <br />Street I'Jt1Nl.~€iF. !3 KAasaw~-a ~~t3> !,~ ~'s74aE~ <br />~_ ~ ~~ 1.484 <br />City: ~~-(~tlg`~-PQfJ <br />State: lt~~ Zip Code: o~,S3~-7 - <br />Brief Description of Revision: <br /> <br />~~Y~I`S7kA-7~ r~7` ~YDROG.OIol~ <br />Public Notice Attached: Yes ~ No _ (Required for PRs and TRs) <br />Bond Increase: Yes _ No ~ Federal Non-Federal _ Mine <br />Proposed Change in: <br />Disturbed Area {+/-) - , Q . _ Acres <br />Permit Area {+/-) p Acres <br />Affected Area (+1-) _ _ C~ ~ _ Acres <br />Federal Land (+/-) p Acres <br />