Laserfiche WebLink
COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />~'., 1313 Shemrnart Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />RECEeWED <br />APPLICATION FORM FOR A REVISION JUL 2 ~ 2001 <br />TO A COAL MINING AND RECLAMATION PERIIg1T , <br />rvisw„ ~i t?~dzmation <br />Mining and Safety <br />This form must be completed and submitted with ell requests for minor revisions, as defined in Rule 1.04(73), <br />technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 1.04(90). All revisons <br />are to address the requirements of Rule 2.08.4. Three (3) copies a the revision, including maps, must be <br />submitted in order for it to be complete. <br />A8 revisions are to be tomcatted so they can be inserted into the permit N replace the revised sections, maps, <br />tables and/or fgures, with a revised table of ~nteMs, if necessary. The revision submittal date should be printed <br />in the Bever right comer of each revision page. A cover letter to the revision should explain the nature of the <br />revison and reference fhe specific permit sections being revised. <br />For federal mines, a copy of the revision application must be submitted to all agencbes on the federal mailing list <br />(except OSM) at the same time the applicatron is sutxnitted fo the Divison, and proof of distribution must be <br />submitted to the Division along with the application. Copies of revision pages modified during the review process <br />must be distributed in the same manner, abng with proof of distribution. Proof of distribution must be submited <br />prior tc implementation of the revision. <br />PermitNo.: C- ~- - 0!3 Date: 07 i Z~_ i ZsJ07 <br />Permlttee: G <br />GO PIA ~!4 gI P. /YJr N,r~ <br />Street: z No+~ CasC A D E r*U ~ <br />lY~ Floolr <br />city: Ca IoJ~ao{p S~r~vi~C <br />srata: ~_ zip code: b 3 _ / ,/ <br />Brief Description of Revision: ~e c~~ y/O~u/rlPl`S~r rA ~ Conld`O~ <br />~z1, r Y-1 a.C / <br />Public Notice Attached: Yes - No ~ (Required for PRs and TRs) <br />Bondlncrease: Yes- NoX Federal )~ Non-Federal - Mine <br />Proposed Change In: <br />Permit Area - <br />Disturbed (+/-) - - - . -Acres <br />Permit (+/-) - - - . -Aces <br />Affected (+/-) - - - . -Acres <br />Mineral Ownership - <br />Mineral Private (+/-) - - - . -Acres <br />Mineral Federal (+/-) - - - . -Acres <br />Surface Ownership - <br />Prirrate Land (+!-) - - - . -Acres <br />Federal Land (+/-) - - - . -Acres <br />State Land (+/-) - - - . - Aaes <br />Mineral State (+l-) - - _ . -Acres <br />