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~' <br />STATE OF COLORADO <br />Roy Romer, Governor <br /> <br />DEPARTMENT OF NATURAL RESOURCES <br />MINED LAND RECLAMATION DIVISI~~° <br />FRED R. BANTA, Dlrsctor <br />Application Form fora Permit 5 (h Q <br />to <br />Conduct Coal Mining in Colorado MINED LAND <br />RECLAMATION DIVISION <br />Application to conduct surface or underground coal mining activities or other <br />surface coal mining and reclamation operations in Colorado pursuant to <br />C.R.S. 34-33-101 et seq. <br />For an application to be deemed complete by the Division pursuant to CRS, <br />34-33-103(5) and Rule 1.04(30), an applicant must: (1) supply all information <br />as specified on this application form; (2) submit five reproducible copies of <br />the permit application with original signatures; and (3) pay the appropriate <br />fee required by Rule 2.01.6. For Federal mines 7 copies must be submitted to <br />OSM in Denver as soon as the application is deemed complete. <br />Please note that this form is only a listing of general category requirements <br />and does not constitute a checklist of detailed permit application <br />requirements. A finding of completeness should not be interpreted to imply <br />adequacy of an application. Additional information not listed on this form <br />may be required for adequacy depending upon the individual circumstances of an <br />application. After a decision has been reached on this application, the <br />operator must update the permit application on file at MLRD and OSM. For <br />non-Federal mines, one copy must be sent to OSM in P.lbuquerque, New laexicn. <br />This form consists of two major parts: (1) a section entitled General <br />Operation Information and (2) a section entitled Application Requirements. <br />Specific instructions for filling in the necessary information for each <br />section appears immediately below the title of each section. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as tasted below. <br />Supplemental sheets may be used as necessary, such sheets must be attached to <br />the form and referenced or keyed to the numbers on the form. <br />1. Application Number (to be filled in by the Division): C- g p - D 5 7 <br />2. Permittee P E A B O D Y C O A L C O M P A N Y <br />- - - - - - - - - - - - - - - - - - - - - <br />3. Mine or Site Name S E N E C A I I- W M I N E <br />- - - - - - - - - - - - - - - - - - <br />4. Current Permit Type: C 0 <br />6. Application Submittal Date: _ _/_ _/_ _ <br />6. Application Fee: 5 _ _ _ _ Incremental Fee Schedule: _ <br />7. Commodity Mined: C 0 A <br />423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203-2273 Tel. (303) 866-3567 <br /> <br />