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¢Op CO <br />:~ COLORADO DIVISION OF MINERALS AND GEOLOGY <br />~e~s ~ 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />APPLICATION FORM FOR A REVISION .wN Z $ 2pO4 <br />TO A COAL MINING AND RECLAMATION PERMIT pivisienofMine~alsandGeology <br />This form must be completed and submitted with all requests for minor revisions, as defined in Rule 7.04(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, v~ith 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 implementatlon of the revision. <br />Permit No.: C - 1981 - 022 Date: ~Une / 23 / 2004 <br />Permittee: Oxbow Mininq, LLC. <br />Elk Creek Mine <br />street: 3737 State Highway 133 <br />PO Box 535 <br />c;ty: Somerset <br />State: CD• Zip Code: 81434 _ <br />Brlef Description Of ReVI510n: MR-73 -- l=zploration Activities at the reclaimed Blue Ribbon Minesite. <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 - Surrace Ownership - <br />Disturbed (+/-) _ _ 0 66 Acres Private Land (+/-) _ _ o , _ Acres <br />Permit (+/-) _ _ a . _ Acres <br />Affected (+/-) _ _ a . _ Acres <br />Mineral Ownership - <br />Mineral Private (+/-) _ _ o -Acres <br />Mineral Federal (+/-) _ _ ~ _ Acres <br />Federal Land (+/-) _ _ o . _ Acres <br />State Land (+/-) _ _ ~ _ Acres <br />Mineral State (+/-) _ _ ° _ Acres <br />