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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 9wmai Street, Room 215, Delver, Colorado 80203, (303) 866-3%7 <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), <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 4 to be complete. <br />All 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 lover 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 OSS) 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 mamer, along with proof of distribution. Proof of distribution must be submitted <br />prior to implementation of the revision. <br />Penn it No.: C- 1981 - 035 Date: 0 8 / 15 / 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: Technical Revision 23: King II - <br />Increase annual production <br />Public Notice Attached: Yes X No _ (Required for PRs and TRs) <br />Bond Increase: Yes _ No X Federal X Non -Federal _ Mine <br />Proposed Change in: <br />Penn it Area - Surface Ownership - <br />Disturbed (+/-) _ _ 0 0 Acres Private Land (+/-) _ _ o 0 Acres <br />Permit (+/-) _ _ 0 . 0 Acres Federal Land (+/-) _ _ . 0 Acres <br />Affected (+/-) _ _ 0. 0 Acres State Land (+/-) _ _ 0 0 Acres <br />Mineral Ownership - <br />Mineral Private (+/-) _ _ 0 . _kAcres Mineral State (+/-) _ _ 0 . o Acres <br />Mineral Federal (+/-) _ _ o 0 Acres <br />