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S¢~`~. <br />`,. COLORADO DIVISION OF MINERALS AND GEOLOGY <br />ns ` 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <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 revisions <br />are to address the requirements of Rule 2.08.4. Three (3) copies of the revision, including maps, must be <br />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 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 distribution 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 - t9t31 - 04t Date: 07 / 08 / 2005 <br />Permittee: Snowcap Coal Company <br />Roadside Portals <br />Street: P.O. Box 1430 <br />city: Palisade <br />State: CO Zip Code: 81526 _ <br />Brief Description Of Revision: Install septic tank and leach field at the unoccupied <br />office/dry that has been converted into a fruit stand. <br />Public Notice Attached: Yes <br />Bondlncrease: Yes No <br />Proposed Change in: <br />Permit Area - <br />Permit {+/-) _ _ 0 <br />Affected (+/_) _ _ 0 <br />Mineral Ownership - <br />Mineral Private <br />Mineral Federal <br />No /. (Required for PRs and TRs) <br />Federal / Non-Federal Mine <br />Surface Ownership - <br />0 Acres Private Land (+/-) _ _ 0 . 0 Acres <br />0 Acres Federal Land (+l-) _ _ 0 . 0 Acres <br />0 Acres State Land (+/-) _ _ 0 . ~ Acres <br />(+/_) _ _ 0 0 Acres Mineral State (+/-) _ _ ~ . 0 Acres <br />(+/-j _ _ 0 0 Acres <br />