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OF COCO\ <br /> �z <br /> o DEPARTMENT OF NATURAL RESOURCES <br /> David H Getches.Executive Director , <br /> MINED LAND RECLAMATION DIVISION <br /> DAVID C. SHELTON, Director <br /> Richard D Lamm <br /> Governor APPLICATION FORM FOR A REVISION <br /> TO A COAL MINING AND RECLAMATION PERMIT <br /> This form must be completed and submitted with all requests for minor revisions, as <br /> defined in Rule 1 .04(73), technical revisions as defined in Rule 1 .04(36) and permit <br /> revisions, as defined in Rule 1 .04(90). All revisions are to address the requirements <br /> of Rule 2.08.4. <br /> All revisions are to be formatted so they can be inserted into the permit to replace the <br /> revised sections, maps, tables and/or figures. Explain in the revision what section is <br /> being revised. The revision date should be printed in the lower right corner of the <br /> revision pages. If necessary, the Table of Contents should also be revised. <br /> Date: 1 1 / 2 1 / 8 6 <br /> Permi ttee: P E A B 0 D Y C 0 A L <br /> — — — — — — — — — — — — — — — <br /> C 0 t1 P A N Y <br /> — — — — — — — — — — — — — — — <br /> Street: 1 3 0 0 — S 0 U T H — Y A L E <br /> City: F L A G S T A F F <br /> itate: A Z Zip Code: 8 6 0 0 1 <br /> Permit No C - 8 1 _ 0 0 8 <br /> This box to be filled in by the Division: <br /> Type of Revision: (PR, TR, or MR) <br /> Revision Number — — (Sequential by Revision Type) <br /> Revision Submittal Date —/ / (Date Received by Division) <br /> Revision Completeness Date —/ /_ Revision Incompleteness Date <br /> Revision Adequacy Due Date —/_/_ Revision Adequacy Date <br /> Revision Decision Due Date / / Fee $0.00 <br /> Brief Description of Revision: C H A N G E _ M I N I N G <br /> M E T H O D —& — S E Q U E N C E <br /> Public Notice Attached - Yes X No (Required for PR's and TR's) <br /> Bond Increase: Yes X No <br /> Proposed Change in: <br /> Disturbed Area (+/-) — — - -_ Acres Affected Area (+/-) 1 4 5 .7* Acres <br /> Permit Ar,pa {�+/-) — — 6 . 6 Acres - Federal Land (+/-) _ 0 * Acres <br /> State Land (+/-) — — 0 Acres Private Land (+/-) 6 . 6 Acres <br /> Lead Reclamation Specialist — — — * Total Affected Acres 6185F <br /> 423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />