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999 <br /> <br />STATE OF COLORADO <br />Roy Romer, Gove <br />DEPARTMENT OFNATURAL RESOURCES <br />MINED LAND RECLAMATION DIVISION <br />FEED R. BANTA, Director APPLICATION FORM FORA REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor revisions, as defined <br />in Rule 1.04(73), technical revisions as defined in Rule 1.04(36) and permit revisions, as <br />defined in Rule 1.04(90). All revisions are to address the requirements of Rule 2.08.4. <br />Three copies of your revision including maps must be submitted in order for it to be complete <br />All revisions are to be formatted so they can be inserted into the permit to replace the <br />revised sections, maps, tables and/or figures. Explain in the revision what section is being <br />revised. The revision date should be printed in the lower right corner of the revision <br />pages. If necessary, the Table of Contents should also be revised. When the final version <br />of the revision is approved, 7 copies must be sent to OSM in Denver for Federal mines and for <br />non-Federal mines 1 copy must be sent to OSM at 625 Silver Avenue, SW, Suite 310, <br />Albuquerque, New Mexico 87102. The revision may not proceed until OSM has been provided <br />copies. Copies should be sent certified mail. <br />Date: _0:6 / ;05 _/ 91 _ <br />Pennittee: N C I_G_ F_ .I -N A N-C I A L -- I-N -C <br />I ~ _ .. .~ <br />r~ ~ I CrC~ I~~~ <br />~reet: 7 9 7 6 E A R K A N S A S ~GV~ <br />N 0 1 0 4 <br />-------------------- 61991 <br />City: D E N V E R--------- JUN <br />state: ~ 0 Zip Code: 8 0 2 3 1 _ _ _ _ _ Mined Land <br />Permit No.: c- a q_ 0 6 s Reclamation Division <br />Mine Name: C O A L R I D G E # 1 <br />75 box t0 be tilled 1^ by the Drvt5lon: <br />Type of Revision: (PR, TR, or MR) <br />Revision Number: _ _ <br />Rev. Submittal Date _ <br />Rev. Completeness Date: <br />Rev. Adequacy Due Date: <br />Rev. Decision Due Date: <br />rrer escrrp ion or e <br />Public Notice Attached <br />Bond Increase: Yes <br />posed Change in: <br />~turbed Area (+/- <br />_ (Sequential by Revision Type) <br />_/_ _/_ _ (Date Received by Division ) <br />- -/- -/- - Rev. Incompleteness Date: ~- -/ -/ <br />_ _/_ _/_ _ Rev. Adequacy Date: _ _/_ _/_ _ <br />/ / Lead Reclamation Specialist: <br />v157on: L 0 A D O U 'T <br />F A C I L I T Y <br />-Yes X ~Jo ~qur r~ 1•or~R's and TR s ) <br />No x -feral Non-Federal x Pline <br />+ 9 4 Acres Affected Area (+/-) + 9 9 Acres <br />r'ermit Area (+/-) - + q ,4 Acres Federal Land (+/-) -_ - - Acres <br />State Land (+/-) -_ -_ -_ - Acres Private Land (+/-) _ + 4 .9 Acres <br />6185E (Rev. 10/88) <br />215 Centennial Building, 1313 Sherman Street Denver, Colorado 80203.2273 Tel. (303) 866.3567 <br />