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�pF•Cp�p� <br /> 90 <br /> DEPARTMENT OF NATURAL RESOURCES <br /> k •r1 p * David H.Getches,Executive Director <br /> MINED LAND RECLAMATION DIVISION <br /> 1876 DAVID C.SHELTON, Director <br /> J <br /> Richard D.Lamm <br /> Govemor 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 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: _QJ L_L/ -9-0— ;� 4. 'k r` <br /> „.s . <br /> Permittee: M;di-raatinaut_Rzsa-ur"s_- - - - - - <br /> 2.0.1—L e4�.t,." a4- —44-9-6— — — — — — — OCT 15 1990 <br /> Street: - - - - _. - - - - - - <br /> - — —— Miner Land <br /> City: .Ll.e.nw zd- S.Rr-a-ng-s - - - - - - - - - - - - - <br /> State: _CO -Zip Code: 81601 - - - - - - - <br /> Permit No. : C - 8 1 - 0 1 7 <br /> This box to be filled in by the Division: <br /> Type of Revision: -T— R— (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: _LD}.&rLLe mi-e—dresin.ag.p— -tre -tz era.t. s cstem. <br /> Public Notice Attached - Yes No (Required for PR's and TR's) <br /> Bond Increase: Yes No <br /> Proposed Change in: <br /> Disturbed Area W-) — — — — Acres Affected Area (+/-) — — — — Acres <br /> Permit Area W-) — — — — Acres Federal Land (+/-) — — — Acres <br /> State Land W-) — — — Acres Private Land (+/-) — — — Acres <br /> Lead Reclamation Specialist —WL�— 6185F <br /> 423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel. i303? c=r.-_� ==- <br />