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DIVISION OF MINERALS AND GEOLOGY <br />Department or Natural Resources <br />1317 Sherman 51., Room 215 <br />Denver. Colorado 90207 <br />Phone. 13031 866-3567 <br />III IIIIIIIIIIIIIIII <br />999 <br />STATE OF COLORADO <br />I~~~~ <br />FAX: 1)071 83 2-81 06 APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT DEPARTME[JI' <br /> NATURA <br /> RESOURC] <br />This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer <br />Rule 1.04(731, Cechnical revisions, as defined in Rule 1.04(361, and permit revisions, as defined ~~~ <br />in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three 131 copies lames s. L«hhead <br />of the revision, including maps, must be submitted in order for it to be complete. I:=ecurf.e Dlrect« <br /> Michael 8. Long <br /> Diveion D~~+~+~ <br />All revisions are to be formatted so they can be inserted into the permit :o replace the revised <br />sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision <br />submittal date should be printed in the lower right comer of each revision page. A cover letter to the <br />revision should explain the nature of the revision and reference the specific permit sections being revised. <br />For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing <br />list at the same time the application is submitted to the Division, and proof of distribution must be submitted <br />to the Division along with the application. Copies of revision pages modified during the review process must <br />be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted <br />prior to implementation of the revision. For non-federal mines, a copy of the application for which the <br />Division has issued a proposed approval decision must be submitted to the OSM Albuquerque Field Office <br />(AFO-, and proof of submittal to AFO must be submitted to the Division prior to implementation of the <br />revision. <br />Permit No.: C - ~ L - _p ~ ;~ Date: ~ ~ / ~ L / ~ -~ <br />Permittee: s g, ~ P_ E~ :.E~ ~- - SL L ~ -S._ ~ ~ --INC <br /> 1 <br />' <br /> {~FCEI\/ED '.~~. <br />street: ~ ~ _ ~ ,_.o x . ~ 8 ~ _ <br />- - - - SEP ~ ~ 1995 <br />Clty. ~ ~ -g' 3 -~ - - - - - - - - - - Division of Mlnerais ~ ueo~ogy <br />State: ~.,~ Zip Code: 8 1 6 2 6_ <br />Brief Description of Revision: 1 9 9 5 T o P S o i L __ <br /> E X C L U S I 0 N _ A R E A <br /> S <br />Public Notice Attached: Yes _ Na t~ (Required for PRs and TRsI <br />Bond Increase: Yes _ No ~ Federal ~ Non-Federal _ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ o . _ Acres <br />Permit Area (+/-) _ _ o . _ Acres <br />State Land (+/-) _ _ ~ . _ Acres <br />Affected Area (+/-) _ _ _ _ Acres <br />Federal Land (+/-1 _ _ _ _ Acres <br />Private Land (+/-) <br />Acres <br />m: \w el\sh ere\f o rms\888 5 <br />