Laserfiche WebLink
co <br /> y° <br /> DEPARTMENT OF NATURAL RESOURCES <br /> i /D ^ o # David H.Getches,Executive Director <br /> ` -~ MINED LAND RECLAMATION DIVISION <br /> 1876 DAVID C.SHELTON, Director <br /> Rmhard 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: 11_/ 13 _/ 9U — <br /> Permittee: M I D _ C 0 N T I N E N T _ — <br /> R E S 0 U R C E S, I N C. — _ — <br /> Street: 2 0 1 — C E N T E N N I A L — <br /> # 4 0 6 <br /> City: G L E N W 0 0 D — S P R I N G Ss - - - - <br /> State: C 0 Zip Code: 8 1 6 0 1 - - _ - - <br /> Permit No. : C - 1 7 - 0 8 1 <br /> This box to be filled in by the Division: <br /> Type of Revision: M— (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: — Install pipeline to 020 pond.— — — — <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 (+/-) — _ — — Acres Affected Area (+/-) — — — _ Acres <br /> Permit Area (+/-) — _ — — Acres Federal Land (+/-) — — — Acres <br /> State Land (+/-) Acres Private Land (+/-) — — _ Acres <br /> Lead Reclamation Specialist 6185F <br /> 423 Centennial Building, 1313 Sherman Street Denver. ^c!oraeo 80203 Tel. (303) 866-3567 <br />