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., ' <br />~~a:~ <br />C/98oo07 <br />N-R - 3~S <br />cQ~~a~tr~ ~izv~te~ ~~ ~~ ~ ~~ECEIVED <br />4t3St[ei2ni~nStreet,IY.~rxiz.ZPS,DZrivn'.Co2©raan S(t~Cs3,~(r'W~)$55.3s~i7 <br /> <br />APPLICATION FORM. FOR A t3EV{SIQN Uivisian ~f Minerals and Geology <br />TO A COAL MINING AND RECLAMATION-PERMIT <br />This form must be completed- and submitted with all tequestS for- minor revisia~s, as defined in Rute 1.04(73}, <br />technical revisions, as defined in Ruie 1.04(136), and permit revisions, as-defned in Rule 1.04(90). Ail revisions <br />are to address the requirements of Rule 2.08.4. ~hree (3} copies of the revision, including maps, musf be <br />submitted in over font to b'e complete. <br />Alt 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 revisetl table or" gontents~ if necessary. The revision. sutimittai date should be printed <br />in the lower .right comet of each revision page. A cove[ fetter to the revision should explain the nature of the <br />revision 'and reference fine specific permit sections being revised. <br />For federal mines, a copy of the revision application must pe submitted to alt agereies on the federal maiiirg list <br />{except OStN) at the same titi3e the appiicatign is submitted to ttie Division, and proof of distribution must be <br />submitted to the t7iwsian along with the application. Copies of mvisiori pages modified iiuring the review process <br />must ha.distisbuted in tTie satne'rnanner, atnrig with proofbf distnhutinn. Proof of diskributfnn must be submitted <br />prior to impiementatton of the rev~ston, <br />Permit No.: C - 80 - ov7 Date: ~ ~ / 21 / 05 <br />Permitt¢e: Mountain Goat C4mpdn~_C. - <br />1)Vest Elk fUline <br />Street: P-.O: BfSx 5'91 <br />city: Somerset <br />State: eO Zip Code: 81434 _ <br />Brief Description of Revision: Minor Revision ND. 319 (MR-319), Pad 8c <br />DrEII Hole(s) 24HS-01, (24HS-02, 24HS-03) <br />Public Notice Attached: Yes No /. (Required forPRs and TRs) <br />Bond increase: Yes / No _ Federal / Non-Federal _ thine <br />Proposed Change in: <br />PermftArea • Surface Qwnership - <br />Disturtied f*/-) - _._ f • ° Acres !?rivaEe Land (+/-1 _ _ ~ c Acres <br />Permit {+/-) _ _ o , o Acres <br />Affected (*G} _ _ ~ ~ `? Acres <br />Mineral Ownership - <br />MiRerat PhTvete f+t } Q 0 Acres <br />-.-.~ <br />Ntin¢Ya( P¢terai (+/-) _ _ d . ~ Acres <br />Fedei'ai hand (.+[-) ^ _ ° - Q Acres <br />State Land (+!-) _ T Q • fl Acres <br />Mirteral State (+f-) __ _~ 0 .'Acres <br />