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oe-co� <br />DO DIVISION OF MINERALS AND GEOLOGY <br />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 <br />1.04(73), technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 1.04(90). <br />All revisions are to address the requirements of Rule 2.08.4. Three (3) copies of the revision, including <br />maps, must be submitted in order for it to be complete. <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, <br />maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal date <br />should be printed in the lower right corner of each revision page. A cover letter to the revision should <br />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 <br />mailing list (except OSNv at the same time the application is submitted to the Division, and proof of <br />distribution must be submitted to the Division along with the application. Copies of revision pages <br />modified during the review process must be distributed in the same manner, along with proof of <br />distribution. Proof of distribution must be submitted prior to implementation of the revision. <br />Permit No.: C - 92 - 081 Date: August 1, 2016 RECEIVED Permittee: Hayden Gulch Terminal, LLC RECEI <br />AUG 0 9 2016 <br />Street: 29515 Routt County Road 27 <br />CDWTT0N <br />MINING AND SAFETY <br />City: Oak Creek <br />State: CO Zip Code: 80467 - <br />Brief Description of Revision: TR -11 updates the hydrology monitoring plan. <br />Public Notice Attached: Yes X No (Required for PRs and TRs) <br />Bond Increase: Yes No X Federal Non -Federal X Mine <br />Proposed Change in: <br />Disturbed Area (+) 0 0 Ac Affected Area (+/-) 0 0 Ac <br />Permit Area (+) 0 0 Ac Federal Land (+/-) 0 0 Ac <br />State Land (+) 0 0 Ac Private Land (+) 0 0 Ac <br />