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COLORADO DIVISION OF RECLAMATION MINING AND SAFETY <br />Rey ° / 1313 Shaman Street Room 215 Denver Colorado 80203 (303) 866 -3567 <br />I I I RECEIVEC3 <br />MAY 16 2014 <br />APPLICATION FORM FOR A REVISION <br />TO A C OAL MIN IN G AN D R EC LAMATION PER MIT Division of Reclamation, <br />Mining & Safety <br />This form must be completed and submitted with all requests for minor revisions, as defined in Rule 1.04(73), <br />technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 1.04(90). All revisions <br />are to address the requirements of Rule 2.08.4. Three (3) copies of the revision, including maps, must be <br />submitted in order for it to be complete. <br />Al revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, <br />tables and/or figures, with a revised table of contents, if necessary. The revision submittal date should be printed <br />in the lower right comer of each revision page. A cover letter to the revision should explain the nature of the <br />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 list <br />(except OSM) at the same time the application is submitted to the Division, and proof of distribution must be <br />submitted to the Division along with the application. Copies of revision pages modified during the review process <br />must be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted <br />prior to implementation of the revision. <br />Permit No.: C- 1981 - 035 Date: 05 / 09 / 2014 <br />Permittee: GCC Energy, LLC <br />Street: 6473 County Road 120 <br />City: Hesperus <br />State: CO Zip Code: 81326 <br />Brief Description of Revision: <br />Minor Revision 38: Identification of <br />Interests Update, King I & King II mines. <br />Public Notice Attached: Yes _ No X (Required for PRs and TRs) <br />Bond Increase: Yes No X Federal X Non - Federal Mine <br />Proposed Change in: <br />Permit Area - Surface Ownership - <br />Disturbed ( + / -) _ _ 0 . o Acres Private Land ( + / -) _ _ 0 0 Acres <br />Perm it ( + / -) _ _ 0 0 Acres Federal Land ( + / -) _ _ o 0 Acres <br />Affected ( + / -) _ _ o . 0 Acres <br />Mineral Ownership - <br />Mineral Private ( +1 -} _ _ o . 0 Acres <br />Mineral Federal ( + / -) _ _ 0 . 0 Acres <br />State Land ( + / -) _ _ _L. 0 Acres <br />Mineral State ( + / -) _ _ 0 .0 Acres <br />