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of Co <br /> �o <br /> �- p DEPARTMENT OF NATURAL RESOURCES <br /> H <br /> David H.Getches.Executive Director <br /> MINED LAND RECLAMATION DIVISION <br /> 1876 DAVID C.SHELTON, Director <br /> Richard D.Lamm <br /> Governor APPLICATION FORM FOR A REVISION <br /> ` <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 Pule 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: 0 8 / 2 0 / 8 6 . <br /> Perini ttee: M I D - C 0 N T I N E N T R AUG- - - - - - - - - - - - - A 2 ,`? 1986 <br /> E S 0 U R C E S _ I N C <br /> - - - <br /> Street: P 0 B 0 X 1 5 8Tsgt .. � <br /> ral <br /> City: C A R B 0 N D A L E <br /> State: C O -Zip Code: 8 1 6 2 3 - -- - - <br /> Permit No. : C - 8 1 - 0 17 <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: T U N N E L —M I N E — D I S <br /> C H A R G E P 0 N D S <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 ( -) — _ 4 . 6 Acres Affected Area (+/-) — — —.— Acres <br /> Permit Area (+/-) N 0 —.— Acres Federal Land (+/-) — — — Acren <br /> State Land (+/-) Acres Private Land (+/-) X — — Acres <br /> Lead Reclamation Specialist — — — 6185F <br /> 423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. (303) 866-3567 <br />