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STATE OF COLORADO <br />MINED LAND RECLAMATION DIVISION ~ of ~o~ <br />Department of Natural Resources ,~~~ <br />Nei <br />13t3 Sherman St., Room 215 ~. ~$ <br />Denver. CO 80203 • ~~ <br />. ~. <br />303 866-3567 'raga' <br />Fa x: 303 832-8106 <br />Roy Ramer, <br />Governor <br />' Fretl R. Banta, <br />APPLICATION FORM FOR A REVISION oivis~on 0~reotor <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This forth must be completed and submitted with all requests far 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 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 mail. <br />Permit No.: C- g 2- 0 5 1, <br />Date: 0 1/ 1 5/ 9 Q <br />Permittee: P E A B 0,~~',_~~~1--- ~~~,_~ _; ~ <br />Street: 1 3 0 0- S O U T H- Y g J~ ,~„ <br />JAN i 7 )va• <br />C i tY ~ F L A ~. ~. 1 g. ~ F - - - - - - 13ec1 M~dl.z,.•,+v <br />State: A Z Zip Code: ~ ~ ~ ~ ~ - - - - - amation uiv:,;io~ <br />Mine Name: S E N E X811.=1~L---------- <br />Brief Description of Revision: ~ ~ ~ L ~ ~ - ~ ~ ~ L ~ ~ pL ~ - <br />.I..A.LLJZ.~-J? IL~L.IL-D_D_6_- <br /> <br />Public Notice Attached -- <br />-Yes _iL No -------------- <br />_ (Required for PR's and TR's) <br />Bond Increase: Yes No ,~ Federal ~_ Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/_) - - ~•~ Acres Affected Area (+/-) - - Q.~ Acres <br />Permit Area (+/-) - - 0 0 Acres Federal Land (+/-) - - ~ Acres <br />State Land <br />(+/-) - - 0 Acres Private Land (+/_) - - 0 Acres <br />6185E (10/90) <br />