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of ca< <br />~e I ~ 9Q DEPARTMENT OF NATURAL RESOURCES <br />y l7 <br />y* ~ ly * Davitl H Getchas, Executive Director <br />•,876/. MINED LAND RECLAMATION DI\ <br />DAVID C. SHELTON, Director <br />Richard D. Lamm <br />Governor APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor revisions, as <br />defined in Rule 1.04(73), technical revisions as defined in Pule 1.04(36) and permit <br />revisions, as defined in Rule 1.04(90). All revisions are to address the requirements <br />of Rule 2.08.4. <br />A11 revisions are to be formatted so they can be inserted Into the permit to replace the <br />revised sections, maps, tables and/or figures. Explain in the revision what section is <br />being revised. The revision date should be printed in the lower right corner of the <br />revision pages. If necessary, the Table of Contents should also be revised. <br />Date : 10/ 0 9/ 8 7 <br />Perini ttee: E M P I R E- E N E j~~-- <br />C O R P O R A T ~~~---- <br />Street: P O- B O X- 6~--_--- ~~~~~~~® <br />---'----'-------- OCT f~1991 <br />City: C R A I G <br />- - - - - - - - - - - - - - - - - - - - <br />State: c o Zip Code: g 1 ~ ~ ~ - Q Q ~ MINED LAND <br />~tECLAMATION DIVISION <br />Permit No C- g l- 0 4 4 <br />This box to be filled in by the Division: <br />Type of Revision: _ _ (PR, TR, or MR) <br />Revision Number - - (Sequential by Revision Type) <br />Revision Submittal Date _/_ / (Date Received by Division) <br />Revision Completeness Date - / / Revision Incompleteness Date -/ / <br />Revision Adequacy Due Date - /_/_ Revision Adequacy Date -/-/_ <br />Revision Decision Due Date / / Fee 50.00 <br />Brief Description of Revision: S T I P U L A T I O N- ~, - <br />2,- 5- 6_ 6 _ R E S ~Q,~~,~~ <br />Public Notice Attached - Yes x No (Required for PR's and TR's) <br />Bond Increase: Yes _ No x <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ 0. 0 Acres <br />Permit Area (+/-) _ _ 0. 0 Acres <br />State Land (+/-) 0 Acres <br />Lead Reclamation Specialist G R S <br />Affected Area (+/_) _ _ Q,~ Acres <br />Federal Land (+/-) _ - .!Z Acres <br />Private Land (+/-) _ _ Q Acres <br /> 6185E <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />