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COLORADO D~VISION OF MI1~tERAI.S AND GEOLOGY <br />• ~,• 1313 Sherman Strest~ Room 215, Deaver, Colorado 802D3, (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 1.04190). All <br />revisions are to address the requirements of Rule 2.08.4. Three (3) copies of the revision, including maps, <br />must be 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, with a revised table of contents, if necessary. The revision submittal date should be <br />printed in the lower right comer 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 OSMI 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 - 81 - 041 Date: ~_ / » / on <br />Permittee: POWDERHORN COAL COMPANY <br />Street: <br />City: <br />PAL154D E, <br />State: C O• Zip Code: nts~s - <br />Brief Description of Revision: Revision to "C" Seam Exploration Mine Boundary <br />Public Notice Attached: Yes _ No X (Required for PRs and TRs! <br />Bond Increase: Yes No X Federal X Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+1-) _ _ 0 . 0 Acres <br />Permit Area (+/-) _ 0 , o Acres <br />State Land (+/-) _ _ a ~ Acres <br />Affected Area (+/-) o 0 Acres <br />Federal Land (+/-) _ _ Q . ~ Acres <br />Private Land (+/-) _ _ U . 0 Acres <br />