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of-octQ. <br /> DEPARTMENT OF NATURAL pESOURCES <br /> wo Y7 David H Getches,Executive Rireclor <br /> MINED LAND RECLAMATION DIVISION <br /> 1876 DAVID C.SHELTON, birector <br /> Rwcnard D Lamm <br /> GDyernDr APPLICATION FORM FOR A REVISION <br /> TO A COAL MINING AND RECLAMATION PERMIT _ <br /> This form must be completed and subm�evisionstted with <br /> asall <br /> definedsin Ru1e for m1�04(36)or iandnpermfit <br /> defined in Rule 1 .04(73), technical <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 cas.beExplaineinithe revisionnto the �what set to ction is <br /> lace e <br /> revised sections, maps, tables and/or figure P <br /> being revised. The revision date should d of printed <br /> ri ntedsi shout dn the -also beower revised.r of the <br /> revision pages. If necessary, the Table <br /> Date: L/ / sue <br /> Permlttee: �— <br /> �� <br /> Street: <br /> City: <br /> State: Zip Code: -- <br /> Permit No. : C <br /> This box to be filled Ln by the Division: <br /> Type of Revision: (PR. TR, or MR) <br /> Revision Numbera_ - (Sequential by Revision Type) <br /> Revision Submittal Date �/ /— (Date Received <br /> Revision Incompleteness <br /> bi <br /> Revision Completeness Date I / Rev Date <br /> Revision Adequacy Due Date —/ / <br /> Revision Adequacy Date <br /> Revision Decision Due Date / Fee $0.00 <br /> o f Revision: <br /> Brief Description <br /> Public Notice Attached - Yes No Required for PR's and TR'S) <br /> Pu --- <br /> Bond Increase: Yes _ No <br /> Proposed Change in: Acres <br /> Disturbed Area (+/-) � — —•,,._. Acres Affected Area (+/-) — — .—�.., <br /> Acres (+/-) Acres <br /> Federal Land <br /> Permit Area (+/-) r .. _�� — Acres <br /> State Land (+/-) — — Acres Private Land {+/-) <br /> b185F <br /> Lead Reclamation Specialist ,VN -, L. <br /> 423 Centennial Building, 1313 Sherman Street Denver, Colorado 80203 Tel-(303) 866-3567 <br /> Mid-Continent Resources, Inc. <br /> Pi20111_'<!;l25 OF'fHl F11:�1()!TS( clrli,BASIN CCIKINU C(_1.�L <br /> III l_t ON 11N1.,N 11tESO['1t('1.',,Inc, 261 Centennial Street <br /> 62�i'1 MNI 11:1.1)ROAD,1,11'i J,,w.o Suite 4()6 Telephone! <br /> 1111 I'm%jjlt()()K, 11,11'Nois 61); l Glenn uoKl Springs, Coloroxlo 816Q1 (303)945-49,98 <br /> June 28, 1990 <br />