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C~LORAI)O DIVISION OF MI~N~ERAT~S Al'~'~ GEOLOGY <br />., <br />~~ 1313 Bhemran~$treot, Rgom 215, Denver, Colorado Sf12fS3, (303) 86G-3567 <br />> ,'~ 'J `> NOV <br />012005 <br />' ~ APPLICATION FORM FOR A RE1LiStON <br />TO A COAL MINING ANO RHCLAMATION PERi~fsion raf Minerals and Geolo9Y <br />This form must pe completed and submitted with all requests for minor revisicns, as defined in Rule 1.04(73), <br />technical revisions, as defined in Rule 1.04(138), and.pemil4 revistons, as defined in Rule 1.04(90). Afl 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 orderfor it to be complete. <br />All revisions are to be formatted so they can be inserted iota the permit to replace the revised sections, maps, <br />tables and/or fgures, with a revised table of contents, if necessary. 1'he revision submittal date should 6e printed <br />in fhe lower right comer of each revision page. A cover IeCer to the revision should explain the nature of the <br />revision and reference foe specific permit sections acing revised. <br />For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing list <br />(except b5M) at the same time the application is submitted to the D'elision,-and proof of distribution must be <br />submitted to the Division along with theapplication. Copies of revision pages modified during the review process <br />must be distributed in the same manner, along with proof of disMbution, Prcof of distribution must be submitted <br />poor to implementation of the revision. <br />Permit No,: C - ao _ oo~ paw; 11 / 02 / 05 <br />Pecmittee: Mountain Coal Company L.L.C.__ <br />West Elk Mine _ __ <br />Street: P•O. Box 591 <br />City: Somerset ______ _ -T <br />State: CO Zip Code: 81434 _ <br />Brief Description of.Revision: Minor fR@VfSIOIj NO. 322 ~{t/1R-322 _~ <br />Three Drill holes an a 1,T5 Acre Pad <br />23HG2~34~G, 23f-fG21:~4:5XC, and <br />23t-iG2E35XC <br />Public Notice Attached: Yes No / _ (Required for PRs and TRS) <br />Bond Increase: Yes / No Federal / Non-Federal Mine <br />Proposed Ghangefn: <br />Permit Area - 8urfaee Ownership - <br />t)isturbed (+/-) __ i ? . o _ Acres Private- Land (+(-) , ~ a o Acres <br />Permit (+l-) _ .T o . o Acres Federal Land {+/-), _ o o Acres <br />Affected {+/_) ~ __ o a Acres State Land {+/-) , _ 0 o Acres <br />Mineral Ownership - <br />MlneralPrivate (+!-) ~ _ 0 , 0 Acres Mineral State (+/-) _., _ ~ ~ Acres <br />Mineral Federal (+/-) _ o . ~ Acres <br />