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cow <br /> �e Q DEPARTMENT OF NATURAL RESOURCES <br /> David K Goich.s,Ex mWe Oh aea <br /> MINED LAND RECLAMATION DIVISION <br /> �876 DAVID C.SHELTON,Director <br /> Richard D.Lamm <br /> Governor <br /> Application Form <br /> Renewal of a Valid, Existing Permit <br /> 1987 to Conduct Coal Mining in Colorado <br /> Thi 1NE LAivU <br /> b"01JAS for successive renewal of a valid, existing permit <br /> to surface or underground mining and reclamation activities or other <br /> surface coal mining and reclamation operations in Colorado pursuant to CRS, <br /> 34-33-101 , et sue. This application form is designed to revise and update the <br /> application-form currently included in your permit application. The right of <br /> successive renewal applies only to lands and activity which were permitted <br /> during the previous term. Extensions of the permit area and significant new <br /> activity within the permit area are subject to the review procedures <br /> applicable to new permit applications, in accordance with Rule 2.08.5(1)(c) <br /> and 2.08.4. Such changes will be handled by the Division as permit revisions, <br /> and will be processed simultaneously with the application for renewal. Other <br /> changes to the permit will be processed as technical revisions or minor <br /> revisions in accordance with Rule 2.08.4. <br /> For a renewal application to be deemed complete by the Division pursuant to <br /> CRS, 34-33-109(7), an applicant must submit: (1) all information as specified <br /> on this application form; and (2) a copy of the newspaper notice; (3) evidence <br /> that a liability insurance policy will be provided for the proposed period of <br /> renewal and (4) five reproducible copies of the permit renewal application <br /> with original signatures. <br /> GENERAL OPERATION INFORMATION <br /> Type or print clearly the appropriate information as listed below. <br /> Supplemental sheets may be used as necessary. Such sheets must be attached to <br /> the form and referenced or keyed to the numbers on the form. <br /> 1. Permi ttee —Mid-Continent Resources, Inc. — — — — — — — —— — — <br /> - - - - - - - - - - - - - -- <br /> 2. Name of Operation: - -Coal Basin—Mines — — — — — — — — — —— — — — — <br /> 3. Permit Number (same as current permit number) : C- 0--17-81 <br /> 4. Type of Revision: R N Renewal Number: 0 1 <br /> 5. Application Submittal Date: 12 / 01/ 87 <br /> 1 <br /> 423 Centennial Building, 1313 Sherman Street Denver,Colorado 80203 Tel.(303)866-3567 <br />