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P COLORADO DIVISION OF NIINERALS AND GEOLOGY <br />~'~' 1313 Sherman S[reet, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />. . .. .. . <br />---~~1VED <br />APPLICATION FORM FOR A REVISION JttN 2 41003 <br />~ TO A COAL MINING AND RECLAMATION PERMIT pivisionotMineralsandGeologp <br />-.,iogY <br />This form must be completed and submitted with all requests for minor revisions, as defined in Rule <br />1.04(731, technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 1.04(901. <br />All revisions are to address the requirements of Rule 2.08.4. Three (31 copies of the revision, including <br />maps, must be 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, <br />maps, tables andfor figures, with a revised table of contents, it necessary. The revision submittal date <br />should be printed in the lower right corner of each revision page. A cover letter to the revision should explain <br />the nature of the 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 <br />list (except OSM) at the same time the application is submitted to the Division, and proof of distribution must <br />be submitted to the Division along with the application. Copies of revisign pages modified during the review <br />process must be distributed in the same manner, along with proof of distribution. Proof of distribution must <br />he submitted prior to implementation of the revision. <br />Permit No.: C - 81 - 012 Date: O1 / 23 ) 03 <br />Permittee: Picketwire Processing LLC <br />Street: 20500 Highway 12 <br />City: Weston <br />State: CO Zip Code: 81091 <br />Brief Description of Revision: <br />of Cover Requirement - Development <br />Waste Pile <br />Public Notice Attached: Yes _X No _, /Required for PRs and TRsI <br />Bond Increase: Yes _ No R Federal _ Non-Federal ~L, Mine <br />Proposed Change in: <br />Disturbed Area (+/-1 _ _ ~ <br />Permit Area (+/-) _ 0 <br />State Land (+/-(_ _ 0 <br />~ Acres Affected Area (+/-) _ _ ~_ 0 Acres <br />~ Acres Federal Land (+/-) _ ~ ~ 0_ Acres <br />~ Acres Private Land (+/-) _ _ _~ ~ Acres <br />m: \co ells have\f orm s188 6 5 <br />