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5~~.~~OLUKAuv <br />r MINED LAND RECLAMATION DIVISION J~~ ~ 3 X92 <br />~~ * Department of Natural Resources <br />t3t3 Sherman St.. Room 215 DIV SIOiv CIF <br />Denver. CO 80203 <br />303 866-3567 MINERALS a ~3Eul_C~'':` <br />FA X.303 832-8706 <br />Application Form <br />Renewal of a Va11d, Existing Permit <br />to Conduct Coal Mining in Colorado <br />pF Or <br />~ o <br />A <br />*1p <br />11/l <br />wf` O <br />f.\~ <br />flry gonrr, <br />Gowror <br />FrW 0. 9an4 <br />OivWOn Oinflv <br />This form 1s an application for successive renewal of a valid, existing .permit <br />to Conduct surface or underground mining and reclamation activities or other. <br />surface coal mining and reclamation operations 1n Colorado pursuant to:.C.R.~. - <br />34-33-101, et sew. This application form is designed to revise and:.update the <br />application form currently included in your permit application:: The: right of <br />successive renewal applies only to (ands and activity which were,perm~itted <br />during the previous term. Extensions of the permit area and sign9ficafit,new <br />activity within the permit area are sub,~ect to the review procedures. -- <br />appitcable to new permit applications, in accordance with Ru le- 2.08.5(1>(.c) . <br />and 2.08.4. Such changes will be handled by the Oivision as permit revisions, <br />and will be processed simultaneously with the application for renewal: Other <br />changes to the permit will be processed as technical rQVistons or minor <br />revisions in accordance with Rule 2.08.4. ., <br />For a renewal application to be deemed complete by the Division pursuant to <br />C.R.S., 34-33-109()), an applicant must submit: (1> all information,-as <br />specified on this application form; and <2) a copy of the newspaper,notice-; <br />(3> evidence that a liability insurance policy will be provided for the <br />proposed period of renewal and (4) five reproducible copies of they'permit <br />renewal application with ori91na1 signatures. At the completion of•thts <br />process, the Federal operation is responsible far provtdtnq one copy of the <br />final revised pages to each of the agencies noted on the Federal.Agenctes <br />Mailing Ltst. For non-federal mines the operation is responsible for _ <br />providing one copy to OSM 1n Albuquerque (Suite 3I0, 6Z5 Silver Avenue, SW, <br />New Mexico 8)102). <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as listed below. <br />Supplementai sheets may he used as necessary. Such sheets"must be attached to <br />the form and referenced or keyed to the numbers on the form. <br />1. Permittee i3v~ct~:E~~;r~Zc#h1d~i:e.z---------------- <br />2. Name of Operation: Q, ~~ ~~,p~~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ <br />_ 3. Permit Number (same as current permit number): C~gO_'_OQ2_ <br />4. Type of Revision: ®N Renewal Humber: 0 L - <br />5. Application Submittal Date: L7_~_1_~.v~L <br />