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ui it~~iiiiniii iii DIVISION OF MINERALS AND GEOLOGY Depanmmr of NaWral Roources 1311 Shmnan Sr.. Room 2 r 5 l7emer. Colorado 80203 Phone: 13D31866.3567 STATE OF COLORADO RECEIVED FA%:13031832.8106 APPLICATION FORM FOR A REVISION TO A COAL MINING AND RECLAMATION PEIa~l1A' 1 1. 2000 Division of Minerals 8 Geology 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 Rule 1.04(136), and permit revisions, as defined in Rule 1.04(90). All revisions are to address the requirements of Rule 2.08.4. Three 131 copies of the revision, including maps. must 6e submitted in order for it to be complete. Ror Romer C,o~ernor lame 5. ladihead Eaecucie 0ireea Mi[liael 8. loot Division Direcrw All revisions are to 6e formatted so they can be inserted Imo the permit to replace the revised sections, maps, tables and/or figures, with a revised table of contents, it necessary. The revision submittal date should 6e printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature of the revision and reference the specific permit sections being revised. For federal mines, a copy of the revision application must 6e submitted to all agencies on the federal mailing list at the same time the application is submitted to the Division, and proof of distribution must be submitted to the Division along with the application. Copies of revision pages modified during the review process must be distributed in the same manner, along with proof of disvibution. Proof of distribution must be submitted prior to implementation of the revision. For non-federal mines, a copy of the application far which the Division has issued a proposed approval decision must be submitted to tfie OSM Western Regional Coordinating Center 11999 Broadway Blvd., Suite 3320, Denver, CO 80202-57331, and proof of submittal to O5M must be submitted to fhe Division prior to implementation of the revision. Permit No.: C - ,~ Z - ~ 5, _1i Date: 0 _ 1 / 1 3 / 0 0 Permittee: T W E ~~~.~. ~~.~ _._---- Street: 1 9- S_ ~ ~ - g ~- 1L L 'L -C-D JJ ~I s Y B Q ~ ~ _ ~ s i - - - - - - - - State: .~ Q Zip Code: ~ Il_ .~ ~ Z - .,- - - - Brief Description of Revision: Northeast Mains Reorientation Public Notice Attached; Yes _ Nom( (Required for PRs and TRs) Borid Increase: Yes _ Nom Federal- Non-Federal _ Mine Proposed Change in: Disturbed Area (+/-) _ .~ . ~ Acres Permit Area (+/-) _ _ 0 0 Acres State Land (+/-) _ _ 0 0 Acres Affected Area (+l-) _ _ ~ . ~ Acres Federal Land (+/_) _ _ 0 0 gcres Private Land (+/.) ` _ 0 0 Acres