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1 <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Depanmenl of Natural Resour[es <br />171 J Sherman SI., Rnom ? 15 I~~~ <br />Denver, Colwado HOHA <br />Phone: Il(DI H66JSh7 <br />FAX: 170718]2-Hl U4 APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT DEP^RT^~NT of <br />NATURAL <br />RESOURCES <br />This form must be completed and submitted with all requests for minor revisions, as defined in Roy Romer <br />Rule 1.04(731, technical revisions, as defined in Rule 1.04(1361, and permit revisions, as defined c°ver"°` <br />in Rule 1.04(90). All revisions are to address the requirements of Rule 2.08.4. Three (31 copies Execuisre D'he<eo. <br />of the revision, including maps, must be submitted in order for it to be complete. <br />Michael H Long <br />Division Di,eclur <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised <br />sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal <br />date should be printed in the lower right corner of each revision page. A cover letter to the revision should <br />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 Western Regional <br />Coordinating Center (1999 Broadway Blvd., Suite 3320, Denver, CO 80202-57331, and proof of submittal <br />to OSM must be submitted to the Division prior to implementation of the revision. <br />Permit No.: C- 8 1- 0 1 4 Date: 0 1/ 0 8 J 9 6 <br />Permittee: ENERGY FUELS COAL, INC. _ _ _ _ _ _ _ DACpIn~11fED <br />SOUTHFIELD MINE _ _ _ _ _ _ _ _ JA 22 996 <br />Street: 1190 Count. Road 9J _ _ _ _ _ _ _ Divisionp(fvffn <br />erals ~ C;eologv <br />P. 0. Box 4r22 _ - _ <br />City: Florence, ___________ <br />State: CO _ Zip Code: 81226 _ _ _ - _ _ _ <br />Brief Description of Revision: S„hG i ~(_~ ~ni tnri nq~ _ _ _ _ _ _ <br />~1i.nnr ~exr j G ion ~lD .-2 B- - - - - - - <br />- - - - - - - - - - - - - - <br />Public Notice Attached: Yes _ No ~ (Required for PRs and TRsI <br />Bond Increase: Yes _ Nog Federal _ Non-Federal g Mine <br />Proposed Change in: <br />Disturbed Area (+ /-) _ _ ~ , ~ Acres Affected Area (+/-) _ _ ~ . ~ Acres <br />Permit Area (+/-) _ _ ~ ,~ gcres Federal Land (+/-) _ _ ~ . Q Acres <br />State Land (+/-) _ _ Q .~ Acres Private Land (+/-) _ _ ~ . Q Acres <br />m:lcoal\sharellorms\aa 65 <br />