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STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Depanment of Natural Resources <br />1713 Sherman 51., Room 215 <br />Denver, Colorado 80203 <br />Phone: 13071 89h~ J 567 <br />MR 170 <br />FA%: (3031 9328106 APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />~~~~~~~~ <br />DEPARTMENT Ok <br />NATURAL <br />RESOURCE <br />This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer <br />Rule 1.041731, technical revisions, as defined in Rule 1 .041361, and permit revisions, as defined cO`~ernOf <br />in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three 131 copies lames 5. Lachhead <br />of the revision, including maps, must be submitted in order for it to be complete. taecuove Diecor <br /> rNichael 9. Long <br /> <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised Division Director <br />sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision <br />submittal date should be printed in the lower right corner of each revision page. A cover letter to the <br />revision should explain 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 at the same time the application is submitted to the Division, and proof of distribution must be submitted <br />to the Division along with the application. Copies of revision pages modified during the review process must <br />be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted <br />prior to implementation of the revision. For non-federal mines, a copy of the application for which the <br />Division has issued a proposed approval decision must be submitted to the OSM Albuquerque Field Office <br />IAF01, and proof of submittal to AFO must be submitted to the Division prior to implementation of the <br />revision. <br />Permit No.: C - ~0 - - COL - Date: 1p - / 17 - / g~ - <br />Permittee: Mountain Coal Company <br />- - - - - - - - - - - - - - - <br />- West Elk Mine - - - - - - - - - - "~j; <br />Street: - P.0_Sox s91 - - - - - - - - - ~FCEIVEU <br />--------------~CT231995 <br />City: - Somerset ----------- <br />State: - CO Zip Code: 81434 - - - - - - DrviSiOn 01 Miner8lslk Geoloyy <br />Brief Description of Revision' Additional Information, Hazardous Waste Disposal <br />Public Notice Attached: Yes - No x /Required for PRs and TRsI <br />Bond Increase: Yes - No x Federal x Non-Federal - Mine <br />Proposed Change in: <br />Disturbed Area (+/-) - - 0 . 0 Acres <br />Permit Area (+/-) 0 0 Acres <br />State Land (+/-) - - ~ ~ Acres <br />Affected Area (+/-) - - 0 . ~ Acres <br />Federal Land (+/-) - - 0 , 0 Acres <br />Private Land (+/-) - - ~ ~ Acres <br />m:1co el\s h ere\fo rm s\8885 <br />