2017-09-26_REVISION - C1981018

• Permit No: C1981018
• IBM Index Class Name: Revision
• Doc Date: 9/26/2017
• Doc Name: Application
• From: Blue Mountain Energy
• To: DRMS
• Type & Sequence: MR172
• Email Name: JDM
• Email Name: DIH
• Media Type: D
• Archive: No

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#� COLORADO DIVISION OF MINERALS AND GEOLOGRECEIVED
• X8,6 + 1313 Sherman Street, Room 215, Denver, Colorado 80203, [phone]
__ -SEP -C 6 2-817-
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APPLICATION FORM FOR A REVISION DivisMining & Safety
TO A COAL MINING AND RECLAMATION PERMIT
This form must be completed and submitted with all requests for minor revisions, as defined in Rule 1.04(73),
technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 1.04(90). All revisions
are to address the requirements of Rule 2.08.4. Three (3) copies of the revision, including maps, must be
submitted in order for it to be complete.
All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps,
tables and/or figures, with a revised table of contents, if necessary. The revision submittal date should be printed
in the lower right corner of each revision page. A cover letter to the revision should explain the nature of the
revision and reference the specific permit sections being revised.
For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing list
(except OSM) at the same time the application is submitted to the Division, and proof of distribution must be
submitted to the Division along with the application. Copies of revision pages modified during the review process
must be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted
prior to implementation of the revision.
Permit No.: C - 1981 - 018 Date: 09 / 21 / 2017
Permittee: Blue Mountain Energy, Inc.
Street: 3607 CR 65
City: Range
State: Co Zip Code: 81648 _
Brief Description of Revision: Addition of backup mine fan.
Public Notice Attached: Yes No ✓. (Required for PRs and TRs)
Bond Increase: Yes ✓ No
_ Federal ✓
Non -Federal _
Mine
Proposed Change in:
Permit Area - (Reduction)
Surface Ownership -
Disturbed (+/-) _ _
0. 0 Acres
Private Land
(+/-) _ _
_ . —Acres
Permit (+/-) _ _
0 , 0 Acres
Federal Land
(+/-) _ _
_ —Acres
Affected (+/-) _ _
0. 0 Acres
State Land
(+/-) _ _
_ . _ Acres
Mineral Ownership -
Mineral Private (+/-) _
_ _ _Acres
Mineral State
(+/-) _ _
_ . _ Acres
Mineral Federal (+/-) _
_ _ —Acres