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<br /> <br />iii iiiiiiiiiiiuiii <br />999 <br />STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION of ~o~ <br />Department of Natural Resources ,~~; 9, <br />1313 Sherman St., Room 215 <br /> <br />Denver, CO 80203 <br />„<~;, ~$ <br />' ~` ~y <br />' <br />303 866-3567 ~ <br />' <br /> <br />Fn x: 303 832-8106 reae <br /> Ray Ramer, <br /> Governor <br /> FreO R. Barra. <br />APPLICATION FORM FOR A REVISION Division Director <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(731, 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) conies 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 - g' q - ~ ~ <br />Date: 0 8 / 1 ~,/ ~ ,~, <br />Permittee: ~ ~ ~ ~ - E ~ ~ ~ ~ ~ L B. ~ L N C. <br />Street: 7476 East Ar]~ry~a,~P,yelyy~: x].03 - - <br />city: ~~.n1-v~B-------- <br />State: ~ 4. Zip Coder ~ ~ 2 i 1 - ~ ~ ~.Z - <br />Mine Name: ~,p~S~11Z.G.~-ALO~1--------- <br />Bri of Descri pti on of Revision: ~ ~~~ ~ ~~~y~pj1ys andllesi.c~, - <br />design of cosl waste disposal facility <br />- - - - - - - - - - - - - - - - <br />Public Notice Attached -Yes X._ No ~ (Required for PR's and TR's) <br />Band Increase: Yes No x Federal Non-Federal ~_ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ _ _ Acres Affected Area (+/=) _ _ _ _ Acres <br />Permit Area (+/-) i ~ Q ,~ Acres Federal Land (+/-) - - - Acres <br />State land (+/-) Acres <br />6185E (10/90) <br />Private land (+/-) <br />Acres <br />