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.1 <br />of • cow Q <br />Q• <br />~ R'O <br />N <br />1 <br />#'M <br />'~ 1876 s <br />Richard D. Lamm <br />Govemar <br />DEPARTMENT OF NATURAL RESOURCES <br />Oavitl M. Gerchea, Executive Diroaor <br />MINED LAND RECLAMATION DIVISION <br />DAVID C. SMFLTON, Director <br />Application Form <br />Renewal of a Valid, Existing Permit <br />to Conduct Coal Mining in Colorado <br />This form is 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 in Colorado pursuant to CRS, <br />34-33-101, et sew. This application form is designed to revise and update. the <br />appiicatlon~onn currently included in your permit application. The right of <br />successive renewal applies only to lands and activity which were permitted <br />during the previous term. Extensions of the permit area and significant new <br />activity within the permit area are subject to the review procedures <br />applicable to new permit applications, in accordance with Rule 2.08.5(1)(c) <br />and 2.08.4. Such changes will be handled by the Division 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 revisions or minor <br />revisions in accordance with Rule 2.08.4. <br />Far a renewal application to be deemed complete by the Division pursuant to <br />CRS, 34-33-104(7), an applicant must submit: (1) all information as specified <br />on this application form; and (2) a copy of the newspaper notice; (3) evidence <br />that a liability insurance policy will be provided for the proposed period of <br />renewal and (4) five reproducible copies of the permit renewal application <br />with original signatures. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as listed 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. Permittee _ _ _cYPxos sM~iRE SQRPQRSTIQN_ _ _ _ _ _ _ _ _ _ _ _ <br />2. Name of Operation: _~~~y~____________________ <br />3. Permit Number (same as current permit number): C ~ ~-044_ <br />4. Type. of Revision: R N Renewal Number: 0 ( <br />5. Application Submittal Date: ~_/~ ~/_~ <br />423 Centennial Building, 7313 Sherman Street Denver, Colorado 80203 7e1. (303) 886-3567 <br />