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a COLORADO DIVISION OF MINERALS AND GEOLOGY <br />•~• 1313 Sherman Stre ,Room 215, Denver, Colorado 80203, (303) 866-3567 <br />~ ,. <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 1.041901. All <br />revisions are to address the requirements of Rule 2.08.4. Three (31 copies of the revision, including maps, <br />must be submitted in order for it to be complete. <br />All revisions are [o 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 <br />printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature <br />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 revision pages modified during the review <br />process must be distributed in the same manner, along with proof of distribution. Proof of distribution must <br />be submitted prior to implementation of the revision. <br />Permit No.: C - 84 - 065 Date: 10 / 18 / O1 <br />Permittee: NCIG FINANCIAL, INC. <br />COAL RIDGE NO. 1 MINE <br />Street: <br />city: <br />State: <br />2768 COMPASS DRIVE <br />SUITE 101 <br />GRAND JUNCTION <br />Co Zip Code: 81506 - <br />Brief Description of Revision: Calculate consumptive use of water at <br />the reclaimed Coal Ridae No. 1 Mine site. <br />Public Notice Attached: Yes _ No Xx (Required for PR's and TR's) <br />Bondlncrease: Yes No xx Federal Non-Federal xX Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ _ 0 . 0 Acres Affected Area (+/-) _ _ 0. 0 Acres <br />Permit Area (+/-) _ _ 0 . 0 Acres Federal Land (+/-) _ _ 0 . 0 Acres <br />State Land (+/-) _ _ 0 . 0 Acres Private Land (+/-) _ _ 0 . 0 Acres <br />