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t . ' COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br /> 1313 Shen-nan Street, Room 215 Den Co ver, lorado 80203, (303 - 5b7 <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 CAM) 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 /> - 1981 022 07 2019 <br /> Permit No.: C Date. <br /> Permittee: OXBOW MINING, LLC. <br /> Street: P.O. BOX 535 <br /> City: SOMERSET <br /> State: CO Zip Code: 81434 <br /> MR-111 INCLUDES: <br /> Brief Description of Revision: <br /> 1) CLARIFICATION OF RECLAMATION SLOPES <br /> 2) GUNNISON ENERGY LLC PIPELINE <br /> ACTIVITIES <br /> Public Notice Attached: Yes No (Required for PRs and TRs) <br /> Bond Increase: Yes No Federal Non-Federal Mine <br /> Proposed Change in: <br /> Permit Area - Surface Ownership - <br /> Disturbed Acres Private Land Acres <br /> Permit Acres Federal Land Acres <br /> Affected Acres State Land Acres <br /> Mineral Ownership - <br /> Miner l Private -Acres Mineral State Acres <br /> Mineral Federal Acres <br />