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• <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />1373 Sherman St.. Room 215 <br />Denver, CO 80203 <br />303 866.3567 <br />Fpx: 303 832.6106 <br />• iii iiiiiiiiiiiii iii <br />999 <br />STATE OF COLORADO <br />OF' Cpl <br />.~E. „ }' <br />~e <br />8~s <br />.~. <br />'tale' <br />Rry Roma. <br />Go~ertar <br />' Fred R. flame, <br />APPLICATION FORM FOR A REVISION Division 0irenor <br />TO A COAL MINING AND RECLAMATION PERMIT <br />This form must be completed and submitted with all requests for minor <br />revisions, as defined in Rule 1,04(73), technical revisions as defined in <br />Rule 1.04(36) and permit revisions, as defined in Rule 1.04(90). All <br />revisions are to address the requirements of Rule 2.08.4. Three (3) copies of <br />your revision including maps must be submitted in order for it to be complete. <br />Ail revisions are to be formatted so they can be inserted into the permit to <br />replace the revised sections, maps, tables and/or figures. Explain in the <br />revision what section is being revised. The revision date should be printed <br />in the lower right corner of the revision pages. If necessary, the Table of <br />Contents should also be revised. When the final version of the revision is <br />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 <br />310, Albuquerque, New Mexico 87102. The revision may not proceed until OSM <br />has been provided copies. Copies should be sent certified mail. <br />Permit No.: C- a i- 0 2 z <br />Date: 0 5/ 2 2/ 9 2 ~'~ ~~~ <br />Permittee: s O M E R S E T- M I N I N G ~~ <br />C O M P A N Y_-_--_---- '~AY26199; <br />Street: P.._ o. - B o x - 5 3 5 - - - - Mi <br />--- i------ Rer.~amaed~n~a" <br />Clty: S O M E R S E T------------ '~ <br />State: C O Zip Code 8 1 4 3 4- _, _, -- <br />Mi rte Name: s A N B O R N C R E E K M I N E <br />-------------.--.----- <br />Brief Description of Revision: R E V I S E- R E C L A M A T I O N <br />E S T I M A T E F O R <br />I N C R E M E N T A L B O N D <br />Public Notice Attached -Yes No x (Required for PR's and TR's) <br />Bond Increase: Yes No x Federal Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/-) - - 0. o Acres Affected Area (+/-) - - p .~ Acres <br />Permit Area (+/-) _ o, o Acres Federal Land (+/-) _ 0 Acres <br />State Land (+/-) - 0 - Acres Private Land (+/-) - 0 Acres <br />