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ST*E OF COLORA D <br /> O <br /> MINED LAND RECLAMATION DIVISION <br /> Department of Natural Resources 0e•co�0 <br /> a`"� � <br /> 1313 Sherman St.,Room 215 <br /> Denver.CO 80203 <br /> 7 t <br /> 303 866-6-3567 <br /> FAX: 303 832-8106 •1876• <br /> Roy Romer, <br /> Govemor <br /> APPLICATION FORM FOR A REVISION oi�fonoriector <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 5 / 1 5 / 9 2 -' r <br /> Permittee: L I L L Y L A N D S I N C <br /> 1 3 199t <br /> Street: P 0 B 0 X 2 0 4 - <br /> - — —V,,"ed ?and <br /> e,,Iamati0n r);,, ,.. I <br /> City: R E _D V A L E _ <br /> State: C 0 Zip Code: 8 1 4 1 3 — — — — — — — <br /> Mine Name: H A M I L T O N _ M I N E <br /> Brief Description of Revision: R E V I S E — M I N E — P L A N <br /> Public Notice Attached - Yes X No (Required for PR's and TR's) — — <br /> Bond Increase: Yes No X Federal Non-Federal Mine <br /> Proposed Change in: <br /> Disturbed Area (+/_) _. 1 2 .0 Acres Affected Area (+/_) __ 1 2 .0 Acres <br /> Permit Area (+/_) — — 0 , 0 Acres Federal Land (+/_) 0 — Acres <br /> State Land _a - Acres Private Land (+/_) — 0 Acres <br /> 6185E (10/90) — i i <br />