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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), technical <br /> revisions, as defined in Rule 1.04(136),and permit revisions, as defined in Rule 1.04(90). All revisions are to address the <br /> requirements of Rule 2.08.4. Three (3) 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,maps,tables and/or <br /> figures,with a revised table of contents,if necessary. The revision submittal date should be printed in the lower right corner <br /> of each revision page. A cover letter to the revision should explain the nature of the revision and reference the specific permit <br /> 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 /> OSM) 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 the <br /> same manner, along with proof of distribution. Proof of distribution must be submitted prior to implementation of the <br /> revision. <br /> Permit No.: C-2009-087 Date: November 19,2019 <br /> Permittee: Peabody Sage Creek Mining,LLC <br /> Street: 29515 RCR 27 <br /> City: Oak Creek <br /> State: Colorado Zip Code: 80467 <br /> Brief Description of Revision: MR32-19,Temporary Painting/Sand Blasting Tent <br /> Public Notice Attached: Yes No X (Requiredfor PRs and TRs) <br /> Bond Increase: Yes No X Federal X Non-Federal Mine <br /> Proposed Change in: <br /> Permit Area- <br /> Disturbed (+/-) 0.0 Acres <br /> Permit (+/-) 0.0 Acres <br /> Affected (+/-) 0.0 Acres <br /> Surface Ownership- Mineral Ownership - <br /> 2.01 Surface Private (+/-) 0.0 Acres Mineral Private (+/-) 0.0 Acres <br /> 2.02 Surface Federal(+/-) 0.0 Acres Mineral Federal (+/-) 0.0 Acres <br /> 2.03 Surface State (+/-) 0.0 Acres Mineral State (+/-) 0.0 Acres <br /> 2.04 <br />