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:~5$ COLORADO DYVISION OF MIlYERALS AND GEOLOGY <br />~_ I313 Sherman S[rerX, Room 215, Deaver, Colorado 80203, (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 1.04(90). 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 corner 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 OSM) 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 - 018 Date: 01 ~ 12 ~ 2001 <br />• Permittee: BLUE MOUNTAIN ENERGY, INC. <br />Street: 3607 CR 65 <br />City: RANGELY <br />State: CO Zip Code: 81648 - <br />Brief Description of Revision: Revision of permit to clarify and document several existing <br />small area exemptions and other miscellaneous issues <br />related to the permit including the addition of one culvert <br />and the deletion of several outdated Illustrations. <br />Public Notice Attached: Yes X No _ (Required for PRs and TRsI <br />Bond Increase: Yes X No Federal X Non-Federal Mine <br />Proposed Change in: <br />Disturbed Area (+/-) _ 6 9 Q Acres Affected Area I+/-) _ _ 0 0 Acres <br />• Permit Area 1+/-) _ _ 0 0 Acres Federal Land (+!-) _ _ 0 ~ Acres <br />State Land (+/-) _ _ ~ 0 Acres Private Land (+1-) _ _ 0 0 Acres <br />