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STA E OF COLORADO <br /> MINED LAND RECLAMATION DIVISION of'�o <br /> �� <br /> Department of Natural Resources a <br /> Sherman St.,Room 215 Den *�* <br /> Denver.CO 80203 <br /> 303 866-3567 •1876 <br /> FAX: 303 832-8106 <br /> Roy Romer, <br /> Governor <br /> Fred R.Banta. <br /> APPLICATION FORM FOR A REVISION Division Director <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/ 2 5/ 9 2 <br /> Permittee: L I L L Y L A N D S I N C <br /> - Lz L' <br /> Street: P._ o. i, s o x i 2 0 4 _ _ MAR 2 7 e992 <br /> —Mined Land <br /> City: R E D V A L E <br /> State: C O Zip Code: 8 1 4 3 1 — <br /> Mine Name: H A M I L T O N <br /> Brief Description of Revision: C H A N G E L O C A T I O N _ <br /> O F M I N E <br /> F A C I L I T I E S <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 (+/-) a 0. o Acres Affected Area (+/-) _ _ 0 10 Acres <br /> Permit Area (+/-) o. o Acres Federal Land (+/-) 0 Acres <br /> State Land (+/-) 0 Acres Private Land (+/-) o Acres <br /> 6185F (10/90) <br />