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of iota <br />yQa OLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 Shennan Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />APPLICATION FORM FOR A 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 in Rule 1.04(73), technical <br />revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 1.04(90). All revisions are to address the <br />requirements of Rule 2.08.4. Three (3) copies of the revision, including maps, must be submitted in order for it to be <br />complete. <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, tables and/or <br />figures, with a revised table of contents, if necessary. The revision submittal date should be printed in the lower right corner of <br />each revision page. A cover letter to the revision should explain the nature of the revision and reference the specific permit <br />sections being revised. <br />For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing list (except OSM) <br />at the same tune the application is submitted to the Division, and proof of distribution must be submitted to the Division along <br />with the application. Copies of revision pages modified during the review process must be distributed in the same manner, <br />along with proof of distribution. Proof of distribution must be submitted prior to implemeaation of the revision. <br />eve <br />Permit No.: C-82-056 R�C'Date: June 17, 2015 <br />Permittee: Twentymile Coal, LLC 192�1� <br />Street: 29515 RCR27 <br />City: Oak Creek sM0g&Safe`! <br />State: Colorado Zip Code: 80477 <br />Brief Description of Revision: 5 -Main North Pipelines (MR15-288) <br />Public Notice Attached: Yes _ No X (Required for PRs and TRs) <br />Bond Increase: Yes <br />X No <br />Proposed Change in: <br />(+/-) 0.0 Acres <br />Permit Area - <br />(+/-) 0.0 Acres <br />Disturbed (+!-) <br />4.6 Acres <br />Permit (+/-) <br />0.0 Acres <br />Affected (+/-) <br />0.0 Acres <br />Surface Ownership - <br />Surface Private <br />(+/-) 0.0 Acres <br />Surface Federal <br />(+/-) 0.0 Acre <br />Surface State <br />(+;-) 4.6 Acre <br />Federal X Non -Federal Mine <br />Mineral Ownership - <br />Mineral Private <br />(+/-) 0.0 Acres <br />Mineral Federal <br />(+/-) 0.0 Acres <br />Mineral State <br />(+/-) 4.6 Acres <br />