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k� <br /> COLORADO DIVISION OF RECLAMATION', MINING,AND SAFETY <br /> "r <br /> 1313 Sherman Street,Room 215,Deaver,Colorado 80203,( 0 )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(7 , technical <br /> revisions,as defined in Rule 1.04 1 ,and permit revisions,as defined in Rule 1.04(90).All revisions are to address the <br /> requirements of Rule 2.08.4. Three ) copies of the revision, including maps, must be submitted in order for it to be <br /> complete. <br /> All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, reaps, tables <br /> and/or figures,with a revised table of contents, if necessary. The revision submittal slate should be printed in the lower <br /> right corner of each revision page. A cover letter to the revision should explain the nature of the revision and reference <br /> 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 except <br /> DM) at the same time the application is submitted to the Division, and proof of distribution must be submitted to the <br /> Division along with the application. Copies of revision pages modified during the review process must be distributed in <br /> the same manner,along with proof of distribution. Proof of distribution must be submitted prior to implementation of the <br /> revision. <br /> Permit No.: C-82456 Date: October 2,2019 <br /> Permittee: Twentymile Coal,LL <br /> Street: 29515 Routt County Road 27 <br /> City; oak Creek <br /> State: Colorado Zip Code: 80467 <br /> Brief Description of Revision: 6MN Passive Treatment Inlet Pipeline Route MOD (MR19- 1 ) <br /> Public NoticeAttached: Yes No X (Requiredfor s and T' s <br /> Bond Increase: Yes No X Federal X Non-Federal Hine <br /> Proposed Change in; <br /> Permit Area <br /> Disturbed 1.4 Acres <br /> Permit 0.0 Acres <br /> Affected 0.0 Acres <br /> Surface Ownership Mineral Ownership <br /> Private Land 0.0 Acres Private Land 0.0 Acres <br /> Federal Land 0.0 Acres Federal Land 0.0 Acres <br /> State Land 1.4 Acres State Land 0.0 Acres <br />