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• <br />.~~~ °~ <br />'~ to DEPARTMENT OF NATURAL RESOURCES <br />~__. <br />~': ,~` DMINED LANDDCRECLAMATION D11 <br />1g76 DAVID C. SNELTON, Director <br />PicrtarC D. Lamm <br />c°"°'"°' APPLICATION FORF1 FOR A REYISiON <br />TO A COAL MINING AND RECLAMATION PER141T <br />This Form must be completed and submitted with all requests for minor revisions, as <br />defined in Rule 1.04(131, technical revisions as defined in P,u1e 1.04(36) and permit <br />revisions, as defined in Rule 1.04(90), All revisions are to address the requirements <br />of Rule 2.08.4. <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 1n the revision what section fs <br />being revised. The revision date should be printed in the lower right corner of the <br />revision pages. If necessary, the Table of Contents should also be revised. <br />Date: 1 1/ 2 8 /9 0 <br />Permittee: p E A B O D Y C D A L ___ ~~..~y,_„~ ., _ <br /> <br />Street: 1 3 0 0_ 5 O U T H_ Y A L E <br /> - ---- ---------- <br />DEC 6 ;~ ~~ <br />City: ~~~~~~~{ F F__, -~~-°dL2nd <br />State: _ ~ Z Zip Code: ~ 6 0 0 1 - _ _ _ Reclamation pi:;;~ion <br />Permit No.: C -~ 0- 0 0 5 <br />This box to be filled in by the Division: <br /> <br />Type of Revision: Zg IPR, TR, or F1R) ~11~IiV`' <br />Revision Number ~ ) (Sequential by P,evislon Type) ./ ~ ~~/ J)~!/U <br />Revision Submittal Oate ~i /~7Q0(Date Received by Division) ~ l_vV_ ll_ ~ <br />P.evision Completeness Date ~Z/lo/~O Revision Incompleteness Date _/ / <br />Revision Adequacy Due Date ~/~/~ Revision Adequacy Date _/ / <br />Revision Decision Due Date a2./~j/9.1 Fee E0.00 <br />Brief Description of Revision: T E M P O R A R Y <br />--------------- <br />I M P 0 U N D M E N T S_____ <br />Dubllc Notice Attached -.Yes X lio (P.equired for PR's and TR's) <br />Bond Increase: Yes No X <br />Proposed Change In: <br />Disturbed Area (+/-) _ _ 0. 0 Acres Affected Area (+/-) _ _ 0. 0 Acres <br />Permit Area (+/-) _ _ 0. 0 Acres Federal Land (+/-1 _ _ 0 Acres <br />State Land (+/_) _ _ 0 Acres Private Land (~/-) _ 0 Acres <br />Lead Reclamation Specialist C ~~ 6185E <br />G33 `~~ <br />423 Centennial Ouilding, 1313 Sherman Slrcel Denver, Colorado 0020 'el. (~0~) 065 3561 <br />+ iii iiiif~iii~~u iii <br />