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STATE OF <br />iii-iiiiiiiiiiiuiii~ _ <br />999 <br />DIVISION OF MINERALS AND GEOLOGY R F C E ~ ~/ E [) <br />l3evartmdu d Na~ural Resources <br />c71„Kr, cr «;ao aoR of 215 OEC 0 5 1996 <br />Phone: X703) 866-3567 <br />FAI(:13031 832.9106 APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RC-CLAMATIQJ,y,R,ERMfTe~_~>.. u,,;;~o;,\ <br />This form must be completed and submitted with all requests for minor revisions, as defined in <br />Rule 1.04(73), technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined <br />in Rule 1.04190). All revisions are to address the requirements of Rule 2.08.4. Three 13- copies <br />of the revision, including maps, must be submitted in order for it to be complete. <br />Ror Yen,er <br />Gocmor <br />wR+ s. lodJ,ead <br />Eaec„ere Dlnva <br />MithaN 9, \0^6 <br />Division OLeCeor <br />All revisions are to be formatted so they can be inserted into the permit to 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 />IAFO-, and proof of submittal to AFO must be submitted to the Division prior to implementation 'of the <br />revision. <br />Permit No.: C - ~ _ - ~1 4- _ Date: _ 12 / ~4_ / _ 9 6 <br />Permittee: F)1LER~yE[JELS MINING~OMPANY _ _' , _ <br />SOUTHFIELD MINE <br />Street: P.O. BOX 449 <br />City: -FLORENCE <br />State: _CO Zip Code: _ 81226 <br />Brief Description of Revision: Revised Post=Mining Topography: Technical Revision <br />No. 26 ~-2~ _ _ <br />Public Notice Attached: Yes ~, No _ (Required for PRs and TRsI <br />Bond Increase: Yes _ Nog Federal _ Non-Federal _ Mine <br />Proposed Change in: <br />Disturbed Area (+/-) 0 . 0 Acres <br />Permit Area (+/-) _ _ 0 , 0 gcres <br />State Land (+/-) _ _ ~ ~ Acres <br />m: \coel\shere\torms\8865 <br />Affected Areai+/-)_ _ 0 <br />Federal Land (+/-) _ - 0 <br />Private Land (+/-) _ _ 0 <br />0 Acres <br />0 Acres <br />0 Acres <br />