REV10108

• Permit No: C1981013
• IBM Index Class Name: Revision
• Doc Date: 8/18/1997
• Doc Name: APPLICATION FORM FOR A REVISION TO A COAL MINING AND RECLAMATION PERMIT
• Type & Sequence: TR47
• Media Type: D
• Archive: No

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STATF, OF COLORADO
DIVISION OF MINERALS AVD GEOLOGY
Dty]rtr~ent of Natuol ReSOUrCm
1 7 7 3 $hcr.nan $! ,Room j l$
Denser. Color]do 80203
Phone: fJO31666-7547
F,~X. 17071 83I-8106 APPLICATION FORM FOR A REVISION
TO A COAL MINING AND RECLAMATION PERMiT
This form must be completed and submitted with all requests far minor revisions. as defined in
Rule 7.04(73), technical revisions, as defined in Rule 1.04(136), and permit revisions: as defined
in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08,4. Three (3) copies
of the revision, including maps, must be submitted in order for it to be complete.
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All revisions are to be formatted so they can be inserted into the permit to replace the revised
sections, maps, tables andlor figures. with a revised table of contents, if necessary. The revision
submittal date should be 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 sectiorLS being revised.
For federal mines, a copy of the revision application must be submitted to all agencies on the federal mairiflg
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 distribution. Proof of distribution must be submitted
prior to implementation of the revision. Far non-federal mines, a copy of the application for which the
Division has issued a proposed approval decision must 6e submitted to the OSM Albuquerque Field Office
(AF01, and proof of submittal to AFO must be submitted to the-Division prior to implementaticn of the
revision. '
Permit No.: C- 8 1_ 0 1 3- Date: ~ ~~ 11~ I~ Z
RECEIVED
Permittee: ~ ~ ? (~ R__E ~ o I1 ~C_E ~ - - - - -
- G O L D E N- E A G L E- M I N A--- AUG 18 1997
Street: 1 4 3 0 0 H I G H W A Y -12 ---_
Division of Mmerdls & Geology
- - - - - - - - - - - - - - -
Ciry: - =-------------
State: C O Zip Code: 8 1 0 9 1- - - - - -
Brief Description of Revision; ~ (Z ~ .l~ ~ 11~ L~ - - - - - - -
L~- (Z ,~ I/ S -E- ~ f- N ~- -- - -
Public Notice Attached: Yes /No - (Required (or PfLs and Ttisl
Bond Increase: Yes - No ~ Federal ~ Non-Federal - Mine
Proposed Change in:
Disturbed Area (+/-) - - - -Acres Affected Area (+/-I _ - - -Acres
Permit Area (+/-1 - - - -Acres Federal Land (+l-} - _ - -Acres
State Land (+/-) - - - -Acres Private Land l+/-) _ _ - -Acres
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