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of <br /> COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> '•, ' 1313 Sherman 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), <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 /> 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 lower right corner 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 - 2010 _ 089 Date: 12 / 20 / 2018 <br /> Permittee: Elk Ridge Mining and Reclamation, LLC <br /> Street: 27646 West 5th Street <br /> P.O. Box 628 <br /> City: Nucla <br /> State: CO Zip Code: 81424 - <br /> Brief Description of Revision: TR-19 updates the as-built for Pond NHN-001 and <br /> NHN-002 to reflect downsizing and reconstruction. <br /> Public Notice Attached: Yesn No❑(Required for PRs and TRs) <br /> Bond Increase: Yes❑Non Federal ❑ Non-Federal❑✓ Mine <br /> Proposed Change in: <br /> Permit Area- Surface Ownership- <br /> Disturbed (+00_0_ _ _Acres Private Land (+/-)0.0_ Acres <br /> Permit (+/-)0.0_ _ _Acres Federal Land (+/-)0.0_ _ . _Acres <br /> Affected (+/-)0_0_ Acres State Land (+/-)0.0_ _ _Acres <br /> Mineral Ownership - <br /> Mineral Private (+/-) 0.0 _ _Acres Mineral State (+/-)0_0_ Acres <br /> Mineral Federal (+/-) 0.0_ _ _Acres <br />