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~: q~J COLORADO DIVISION OF MINERALS AND GEOLOGY <br />~~- 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />RECEIVED <br />APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT NOV 12 2003 <br />This form must be completed and submitted with alt requests for minor revisions, a defrn~} m Rule 1.04(73), <br />technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in ~t)Y~~~:04(~i9~ra1Ql9~r~eet~tons <br />are to address the requin:ments of Rule 2.08.4. Three (3) copies of the revision, including maps, must be <br />submitted in order for it to tie 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 printed <br />in the lower right comer of each revision page. A cover letter to the revision should explain the nature of the <br />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 list <br />(except OSM) at the same time the application is submitted to the Division, and proof of distributon must be <br />submitted to the Division along with the application. Copies of revision pages modified during the review process <br />must be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted <br />prior to implementation of the revision. <br />Permit No.: C - 1981 _ 028 <br />Date: 11 / 10 / 2003 <br />Permittee: Coors Energy Company <br />Street: P • 0. ;Box 467 <br />City: <br />Golden <br />State: CO Zip Code: 80402 _ 0467 <br />Brief Description of Revision: Change of Coal Supply /Source of Ash <br />Public Notice Attached: Yes x No (Required for PRs and TRs) <br />Bond Increase: Yes __ No % Federal _ Non-Federal % Mine <br />Proposed Change in: <br />Permit Area - <br />Disturbed (+/-) _~ _ _ _ Acres <br />Permit (+/-) _0 _ _ _ Acres <br />Affected (+/-) _0 _ _ . _ Acres <br />Mineral Ownership - <br />Mineral Private (+/-) 0 _ _ -Acres <br />Mineral Federal (+/-) 0 _ _ _ Acres <br />Surface Ownership - <br />Private Land (+/-) ~ _ _ _ Acres <br />Federal Land (+/-) ~ _ _ . _ Acres <br />State Land (+/-) 0 _ _ . _ Acres <br />Mineral State (+/-) 0 _ ^ _ Acres <br />