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pf C <br />•' ~ <br />COLORADO DIVISION OF NLINERALS AND GEOLOGY <br />1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 ~ <br />APPLICATION FORM FOR A REVISION FEB 2/8~ <br />TO A COAL MINING AND RECLAMATION PERMdT. <br />rvision of Minerals & <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 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. <br />Permittee: <br />Street: <br />C - 1981 - 022 Date: 02 / 28 / 2003 <br />Oxbow Mining, LLC. <br />3737 State Highway 133 <br />P.O. Box 535 <br />City: Somerset <br />RECEIVED <br />MAR 0 5 2003 <br />State: CO Zip Code: $1434 _ Division of tdmerals a Geology <br />Brief Description of Revision: Minor Revision, MR66 <br />Addition of potable water filtration and chlorination plant <br />building. <br />Public Notice Attached: Yes No / (Required for PRs and TRsJ <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 (+/-) _ _ o , _ Acres <br />Affected (+/-) _ _ a . _ Acres <br />Mineral Ownership - <br />Mineral Private (+/-) _ _ ~ -Acres <br />Federal Land (+/-) _ _ o _ Acres <br />State Land (+/-) _ _ ~ _ Acres <br />Mineral State (+/-) _ _ ~ _ Acres <br />Mineral Federal (+/-) _ _ ~ _ Acres <br />