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~4 e .~. ~ 816 ~ COLORADO DIVISION OF MINERALS AND GEOLOGY 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 APPLICATION FORM FOR A REVISION RECEIVED TO A COAL MINING AND RECLAMATION PERMIT NOV 1 0 2G~J5 0iuision of Minerals and Geology This form must be completed and submitted with all requests for minor revisions, as defined in Rule 1.04(73), technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 1.04(90)cAll_.~ -- - revisions are to address the requirements of Rule 2.08.4. Three (3) copies of the revision, including maps, must be submitted in order for it to be complete. All revisions are to be formatted so they can be inserted into the permit to replace the revision sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal date should be printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature of the revision and reference the specific permit sections being revised. For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing list (except OSM) at the same time the application is submitted to the Division, and proof of distribution must be submitted to the Division along with the application Copies of revision pages modified during the review process must be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted prior to implementation of the revision. Permit No.: C - 80 001 Date: 11 / 9 / 2005 Permittee: The Pittsburg & Midway Coal Mining Co. Street: 116 Inverness Drive, Suite 207 City: Englewood State: CO Zip Code: 80112 - Brief Description of Revision: Update Exhibit 3.5-7 which is labeled as "Retained Roads and Culverts". Public Notice Attached: Yes _ No X (Required for PRs and TRs) Bond Increase: Yes No X Federal X Non-Federal Mine Proposed Change in: Disturbed Area (+/-)_ _ 0 . 0 Acres Permit Area (+/-) _ _ 0 . 0 Acres State Land (+/-) _ _ 0 . 0 Acres Affected Area (+/-) _ _ 0 . 0 Acres Federal Land (+/-)_ _ 0 . 0 Acres Private Land (+/-)_ _ 0 . 0 Acres