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~A~ <br />m~5~ <br />g~E~EiVE® <br />COLORADO DIVISION OF MINERALS AND GEOLO~CR ~ 1 2802 <br />1313 Sherman Street, Rourn 2I5, Denver, Colorado 80303. (303) 866-3167 <br />n'vision of Minerals and Geology <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), <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 comer 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 appliption 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 - 81 - 041 Date: 03 / 08 / 02 - <br />Permittee: Powderhorn _Coal Comnan <br />Roadside Mines <br />Street: P.O Box 1430 <br />City: Palisade <br />State: CO Zip Code: 81526 - <br />Brief Description of Revision: Clarifv seed mixes and rock arounin <br /> requ irements <br />Public Notice Attach ed: Yes _ No XX (Required for PR's and TR's) <br />Bond Increase: Yes _ No XX Federal XX Non-Federal _ Mine <br />Proposed Change in : <br />Permit Area - Surface Ownership - <br />Disturbed (+/-) _ _ 0. 0 Acres Private Land (+/-) _ _ 0. 0 Acres <br />Permit (+/-) _ _ 0 . 0 Acres- Federal Land (+/-) _ _ 0 . 0 Acres <br />Affected (+/-} _ _ 0 . 0 Acres State Land (+/-) _ _ 0 . 0 Acres <br />Mineral Ownership - <br />Mineral Private (+/-) _ _ 0. 0 Acres Mineral State (+/-) _ _ 0 . 0 Acres <br />Mineral Federal (+/-) _ _ 0. 0 Acres <br />