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<br />OF'C < <br />f O+~.. <br />COLORADO DIVISION OF MINERALS AND GEOI)VED <br />~e,s• 1313 Sherman Stree[, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />APPLICATION FORM FOR A REVISION Division of Minerals 8 Geology <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 far it to be cromplete. <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 fetleral 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 - 1983 059 Date: February / 23 / 2006 <br />Permittee: Terror Creek Loadout <br />Terror Creek Company <br />Street: 43440 Bowie Road <br />City: Paonia <br />State: C~• Zip Code: 81428 _ <br />Brief Description of Revision: MR-23 --Portable Truck Scale <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 (+/-) _ _ o _ Acres Private Land (+/-) _ _ o . _ Acres <br />Permit (+/-) _ _ a . _ Acres <br />Affected (+/-) _ _ ~ . _ Acres <br />Mineral Ownership - <br />Mineral Private (+/-) _ _ ~ -Acres <br />Mineral Federal (+/-) _ _ ~ _ Acres <br />Federal Land (+/-) _ _ o . _ Acres <br />State Land (+/-) _ o _ Acres <br />Mineral State (+/-) _ _ o _ Acres <br />