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STATE OF COLORADO <br /> MINED LAND RECLAMATION DIVISION t: co <br /> Department of Natural Resources <br /> 1313 Sherman St..Room•215 *rt� '�° • <br /> Denver.CO 80203 '�J876 <br /> 303 866-3567 1s?6; <br /> FAX. 303 832-8106 <br /> Governor <br /> Fred R.Banta. <br /> APPLICATION FORM FOR A REVISION Division Director <br /> TO A COIL 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 - 8 1 - 0 1 7 <br /> Date: 7 / 1 8 / 9 3a <br /> Permittee: LpUti,mp,nt B.esnt�esr Inc. — — — <br /> . _ - -- - -- -- - - - - -- - - - JUL 201993 <br /> Street: P.O. Box 129�8 <br /> City: Glenwood_S=jng,-., _ - - - - - - - - <br /> State: _ C O Zip Code: 81602— - — — — <br /> Mine Name- <br /> Brief Description of Revision: — Up.2;(=ej t _.t_o_raad_p]an= realama£iom.. <br /> Public Notice Attached - Yves X No w (Required for PR's and TR's) <br /> Bond Increase• Yes No Federal X Non-Federal � Mine <br /> Proposed Change in: <br /> Disturbed Area (+/-) Acres Affected Area (+/-) — — —•— Acres <br /> Permit Area (+/-) — Acres Federal Land Acres <br /> State Land (+/-) Acres Private Land (+/-) — — — Acres <br /> 6185F (10/90) <br />