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STATE OF COLORADO
<br /> MINEECI LAND RECLAMATION DIVISION
<br /> 'Ural Resuurce,i
<br /> -rt a,i,i,
<br /> 2 1 7
<br /> J,
<br /> Frvd R Banta,
<br /> WLICAM)N "FORM rOP. A REVISION owisjon DIF"Or
<br /> TO A COAL MINING AND RECLAMATION PENMIT
<br /> n ,, m. st be co;,,pl,i'ted and sibmitted with all requests for miplor
<br /> V i�,- 1 on S a,-: defined ir, Rule 1 04(73 ), technical revisions as defined in
<br /> and revisio,,s , as dofined in Rule 1 .04(90) . All
<br /> q!,s on 6r�- to the rL-'qLire-,nnts of Rule L 2 .08.4. Three (3' copies of
<br /> in"'ludirg maps rmist be submitted in order for It to be complete.
<br /> Fii rey i sion6 are t;-'.,- .,& fLraiattcd ,�j they Ca;i be fnsi'rted into the permit to
<br /> Vhe revised se,,clicns. raps , tables and./or figures, Explain in the
<br /> Cectlion III being T€'ie revision date 0WId be printed
<br /> right of revislor, pages. if nacpsw- the Tal)l e of
<br /> version of the revision is
<br /> d &I iri De revises.. Wlieri the fira
<br /> approved, 7 copies mst be sertt, to OSM in Denver for Federal mines and for
<br /> ral :nines �: �.I copy uvs- bent to OSM at 625 Silver Aver.'-e, SW, Suite
<br /> 37 0 1 bu e rqu e ew Wx I co 8i102. Tile revision may not pr,;ceed until OSM
<br /> ha,7 been pr yided copies . Cnpi;ts sh,>alld be sent certified mall .
<br /> Pt%rn)lt No. : C
<br /> Date': " —.19
<br /> P r mi t tee., cj
<br /> Street
<br /> -.1 .1201
<br /> City'. Ue Ix Q.�Lci.1,i 1.1.,i E4., cL
<br /> State: Zip Code.,
<br /> Mine Name:
<br /> Brief Description of Revision:
<br /> Public Nctiv-e Attached Yes Ho (Required for PR's and TR's)
<br /> Bond Increase: Yes No Federal Non-Federal Mine
<br /> Pro,,osedl Lhange in:
<br /> Dis,"-�4rtled Area Acres Affected Area Acres
<br /> Per-nit Area acres Federal, Land r. Acres
<br /> St,lte Land P,C.r e S Private .and Acres
<br /> 6185E ( 10/901,
<br />
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