2008-04-22_PERMIT FILE - C1981017 (8)

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EQ' ~~v~''.~ ~p ~, ~., o ~ X876 ~ Richard D. Lamm Governor DEPARTMENT OF NATURAL RESOURCES David H. Getches, Executive Director MIND LAND RECLAMATION DI\ DAVID C. SHELTON, Director APPLICATION FORM FOR A REVISION TO A COAL MINING AND RECLAMATION PERMIT This form must be completed and submitted with all requests for minor revisions, as defined in Rule 1.04(73), technical revisions as defined in Pule 1.04(36) and permit revisions, as defined in Rule 1.04(90). All revisions are to address the requirements of Rule 2.08.4. All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, tables and/or figures. Explain in the revision what section .is being revised. The revision date should be printed in the lower right corner of the revision pages. If necessary, the Table of Contents should"also be revised. Date : - ~/ ~ ~/ ~~ Street: 2s21.-.~~sl~~.~-b1-Z~..]..~- '~ t~-.~..~----------- AUG 121988 city: ~ L.~S1~ ~~ ~.-~~.i3~~~~--~l-IAlEDLANQ ~_~ State: ~ ~ ~ Zip Code: ~ ~ ~ ~ 1 - - - - - RECLAIVIATI~N DIVI~I~hi Permit No.: C - 1 Z - ~ ~ ~ This box to be filled in by the Division: Type of Revision : ~ ~ (PR, TR, or h1R ) Revision Number ~ ~„(Seouential by Revision Type) Revision Submittal Date _/_/ (Date Received by Division) Pevision Completeness Date / / Revision Incompleteness. Date -/ / Revision Adequacy Due Date -/ / Revision Adequacy Date -/ / Revision Decision Due Date / / Fee X0.00 Brief Description of Revision : ~ ~ ~ ~ ~ ~.. ~. - ~ ~, ~ ~ - - _ ~. .~~1- LET-~~. -~~.-~1-~-- -- Public Notice Attached -Yes No /~(Required for PR's and TR's) Bond Increase: Yes ~ No Proposed Change in: Disturbed Area (+/-) _ Acres Affected Area (+/-) Acres Permit Area (+/-) _ _ _ _ Acres Federal Land (+/-) _ - - Acres A State Land (+/-) _ _ - Acres Private Land (+/-) - _ - cres Lead Reclamation Specialist ~, Z _ 6185E 423 Centennial Buildinc, 13 i 3 S-erma~~ Street Denver, Colorado 80203 Tel. (303) 860-3507 >s_s ~.