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iii iiiiiiiui DIVISION OF MINERALS AND GEOLOGY [kpanrtxrn d NaLUral Resource STATE OF COLORADO RECEIVED IJD~]~frGroml~nas~tpgp p32t5 MAY 1 g 2000 PMre:r3031966-3567 FAx: 0031 H32-8106 APPLICATION FORM FOR A REVISIOI~ivision of MineralsBGeology TO A COAL MINING AND RECLAMATION PERMIT This form must be cempleted and submitted with all requests for minor revisions, as defined in Rule 1.04(731, technical revisions, as defined in Rule 1.0411361, and permit revisions, as defined in Rule 1.041901, All revisions are to address the requirements of Rule 2.08.4. Three (31 copies of the revision, including maps, must be submitted in order for it to be complete. NATURAL RESOURCES Ror Ramer Go,arru Woes 5. Lodihead Eaecvnve Oiraoa MR1iad R. Lars Oivnion Oirecta All revisions are to be 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, 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 spedfic permit sections being revised. For federal mines, a copy of the revision application must be 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 distribution. Proof of distribution must be submitted prior to implementation of the revision. For non-federal mines, a copy of the application for which the Division has issued a proposed approval decision must be submitted to the OSM Western Regional Coordinating Center 11999 Broadway Blvd., Suite 3320, Denver, CO 80202-57331, and proof of submittal to OSM must be submitted to the Division prior to implementation of the revision. Permit No.: C-~ Z- ~ ~. ~ Date: 0_ 5 f 1 S i 0 0 Pemtittee: T W E ~1 ~ v ~ ~ ~ ~ ~ Q ~~- L~ ~~A1>L~.---- Street: .Z 9_ S_ ~ ~ - g JZ 1.L L L ~~ JJ ~I S Y ~. Q ~ ~ - ~ 1 Z - - - - - - - - City: Q ~ L-~ ~. ~ E-~--------- State: ~ Q Zip Code: ~ ~ ~ ~ L - - - - - Brief Description of Revision: Installation of NMD Power Borehole Public Notice Attached: Yes X No- (Required for PRs and TRs) Bond Increase: Yes X No- Federal Non-Federal -Mine Proposed Change in: Disturbed Area (+l-) - - ~ 8 Acres Affected Area (+l-) - ~ - . _ Acres Permit Area (+~_) - - ~ -Acres Federal Land (+~.) _ 0 _ -Acres State Land (+~_) _ - 0 -Acres Private Land (+1-) - 0 - -Acres