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� COro <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 SEA Z� 202� <br />This form must be completed and submitted with all requests for minor revisions, as definlrl%,), <br />technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 'PWIGA64' 1v ions <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 - 1980 _ 004 Date: 09 / 25 / 2020 <br />Permittee: ARC McClave Canyon, LLC <br />Street: <br />McClane Canyon Mine <br />2352 N 7th Street, Unit B <br />City: Grand Junction <br />State: CO Zip Code: 81501 _ <br />Brief Description of Revision: Transfer permit from McClane Canyon Mining, LLC to ARC <br />McClane Canyon, LLC. Update identification of interests in the <br />permit for new owner, ARC McClane Canyon, LLC. <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 <br />Mineral Ownership - <br />Mineral Private (+/-) _ _ _ . _Acres <br />State Land (+/-) _ _ _ —Acres <br />Mineral State (+/-) _ _ _ . _ Acres <br />Mineral Federal (+/-) _ _ — —Acres <br />