1988-08-11_REVISION - C1981017

• Permit No: C1981017
• IBM Index Class Name: Revision
• Doc Date: 8/11/1988
• Doc Name: Bid Documents ‎(IMP)‎ Revision MR-12
• Type & Sequence: MR12
• Media Type: D
• Archive: No

of CO�o
p DEPARTMENT OF NATURAL RESOURCES
* 1 0 * David H.Getches,Executive Director
MINED LAND RECLAMATION DIVISION
ION
DAVID C.SHELTON, Director
Richard D.Lamm
Governor APPLICATION FORM FOR A REVISION
TO A COAL MINING AND RECLAMATION PERMIT
This form must be completed and submitted with all requests for minor revisions, as
defined in Rule 1 .04(73), technical revisions as defined in Pule 1 .04(36) and permit
revisions, as defined in Rule 1 .04(90). All revisions are to address the requirements
of Rule 2.08.4.
All revisions are to be formatted so they can be inserted into the permit to replace the
revised sections, maps, tables and/or figures. Explain in the revision what section .is
being revised. The revision date should be printed in the lower right corner of the
revision pages. If necessary, the Table of Contents should'also be revised.
Date: — I/ 1 \/ 5 .2
Permittee: �� ,� _ � tD � _� 1y
Street: -L-) 3- - � 1_ �l �Z l.. -
City: G L a31 � � - - � � � �� - - - -
State: (:�,_ S) -Zip Code:Permit No. : C - _),_ Z - .L
This box to be filled in by the Division:
Type of Revision: n j�- (PR, TR, or MR)
Revision Number t (Sequential by Revision Type)
Revision Submittal Date _/_/_ (Date Received by Division)
Revision Completeness Date _/ / Revision Incompleteness Date
Revision Adequacy Due Date —/ / Revision Adequacy Date
Revision Decision Due Date / / Fee $0.00
Brief Description of Revision: —
Public Notice Attached - Yes No ►/(Required for PR's and TR's)
Bond Increase: Yes '✓ No
Proposed Change in:
Disturbed Area (+/-) _ _ _ Acres Affected Area (+/-) — — — — Acres
Permit Area (+/-) _ _ —_ _ Acres Federal Land (+/-) — — — Acres
State Land (+/-) Acres Private Land (+/-) — — — Acres
Lead Reclamation Specialist CZ _ 6185F
423 Centennial Building, 1313 Snerman Street Denver, Colorado 80203 Tel. [phone]