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STATE OF COLORADO <br /> MINED LAND RECLAMATION DIVISION Ot CO <br /> �o <br /> Department of Natural Resources <br /> 1313 Sherman St.:Room 215 ; w <br /> Denver.CO 80203 «�s <br /> 303 866-3567 1876 a <br /> FAX: 303 832-8106 <br /> Roy Romer, <br /> Governor <br /> Fred R.Banta, <br /> APPLICATION FORM FOR A REVISION DivisionDlreClor <br /> TO A COAL MINING AND RECLAMATION PERMIT <br /> This form must be completed and submitted with all requests for minor <br /> revisions , as defined in Rule 1 .04(73), technical revisions as defined in <br /> Rule 1 .04(36) and permit revisions, as defined in Rule• 1 .04(90). All <br /> revisions are to address the requirements of Rule 2.08.4. Three (3) copies of <br /> your revision including maps must be submitted in order for it to be complete. <br /> All revisions are to be formatted so they can be inserted into the permit to <br /> replace the revised sections, maps, tables and/or figures. Explain in the <br /> revision what section is being revised. The revision date should be printed <br /> in the lower right corner of the revision pages. If necessary, the Table of <br /> Contents should also be revised. When the final version of the revision is <br /> approved, 7 copies must be sent to OSM in Denver for Federal mines and for <br /> non-Federal mines 1 copy must be sent to OSM at 625 Silver Avenue, SW, Suite <br /> 310, Albuquerque, New Mexico 87102. The revision may not proceed until OSM <br /> has been provided copies. Copies should be sent certified mail . <br /> Permit No.: C - 9 1 - 0 7 8 <br /> Date: 0 3/ 3 0/ 9 2 <br /> Permittee: L I L L Y L A N D S — I N C <br /> ._ - - -- _. •- - _. — _. •- -- OAR 31 199re. <br /> Street: P. O. B 0 x _ 2 0 4 _ Mined Land <br /> City: R E D V A L E _ — — <br /> State: C O Zip Code: 8 1 4 3 4 <br /> Mine Name: H A M I L T O N <br /> Brief Description of Revision: R E V I S E S E D I M E N _Z <br /> P O N D — A <br /> Public Notice Attached - Yes No x (Required for PR's and TR's) <br /> Bond Increase: Yes No x Federal Non-Federal x Mine <br /> Proposed Change in: <br /> Disturbed Area (+/-) 0 . 0 Acres Affected Area (+/-) o . o Acres <br /> Permit Area (+/-) — 0 . 0 Acres Federal Land (+/-) i — Acres <br /> State Land (+/-) 0 Acres Private Land (+/_) a 0 Acres <br />