REV14555

• Permit No: C1981020
• IBM Index Class Name: Revision
• Doc Date: 6/30/1995
• Doc Name: APPLICATION FORM FOR A REVISION TO A COAL MINING AND RECLAMATION PERMIT
• Type & Sequence: MR13
• Media Type: D
• Archive: No

r RECEIVED REC~IV~D,
JUL 0 5 1995
~~I ~~~~~~~~~~~~~~~~
999
~~~~ ~~ ~'~TATE OF COLORADO
i)ivision of rvunerals & Geology
DIVISION OF MINERALS AND GEOLOGY
Depanmcnl of Natural Resources OivlSion Of Is~inerals r:r G~ol6gy
Grand Junction ~~~~
1713 Sherman 51., Room 215
Denver, ColoraAo 80203
Phone: [phone]
FA%:13031 B32-8106 APPLICATION FORM FOR A REVISION
TO A COAL MINING AND RECLAMATION PERMIT DEPARTtvtENT OI
NATURAL
RESOURCE
This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer
Rule 1.041731, technical revisions, as defined in Rule 1 .041361, and permit revisions, as defined cover°°~
in Rule 1 .04190). All revisions are to address the requirements of Rule 2.08.4. Three 13) copies lames 5. Lochhpad
of the revision, including maps, must be submitted in order for it to be complete. t.e<uuveDire<i°`
Michael B. Long

All revisions are to be formatted so they can be inserted into the permit to replace the revised Division Dveclor
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 specific 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 Albuquerque Field Office
(AFOI, and proof of submittal to AFO must be submitted to the Division prior to implementation of the
revision.
Permit No.: C - 8 ~ - ~ 2 d Date: a ~o/ ? 9 / 9 S
Permittee: ~ ~ A N j~ _ ~ ~ L L ~
Co ~~-CQ--------
Street: C d_~Q~_ZQ____ __
- -
City: L. ~ - - -
/~~- - - -
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State: ~- ~ Zip Code : B ~ 5 2 ~- _ _0 ~_ ? ~
Brief Description of Revision: ~ £ ~ L ~ ~ _ S ~ ~
- - - - - - - - - - _ 3
- - - -

Public Notice Attache
d: Yes _ - - - - - - - - - -
No x /Required for PRs and TRsI - - - -
Bond Increase: Yes _ No ~ Federal X Non-Federal _ Mine
Proposed Change in:
Disturbed Area (+/-) _ _ ~ . _ Acres Affected Area 1+/-) _ _ ~ . _ Acres
Permit Area (+/-) _ _ Q . _ Acres Federal Land (+/-) _ _ ~. _ Acres
State Land (+l-) _ _ Q . _ Acres Private Land (+1-1 _ _ ~. _ Acres
m:lcoells here\forms\8865