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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />•j$,,6? 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 9.04(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 compleb-- <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 bower right corner 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 revue. <br />For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing fist <br />(except OSM) at the same time the application is submitted to the Division, and proof of dis6thution must be <br />submitted t0 the D vaon Wong with time won. Copies of revision pages modified during the review process <br />must be dmtnbuted in the same manner, along with proof of distribution. Proof of dstnbution must be submitted <br />prior to imp emenhation of the revision. <br />Permit No.: C - 81 - o u Date: <br />permittee. New Elk Coal Company <br />Golden-Eagle Mine <br />street 34115 County Road 20.8 <br />City: <br />State: <br />Trinidad <br />CO Zip Code: 81082 - <br />Brief Description of Revision: <br />Public Notice Attached: Yes _ No k (Required for PRs and TRs) <br />Bond Increase: Yes _ NoX Federal - Non-Federal _ Mine <br />Proposed Change in: <br />Permit Area - <br />Disturbed o - Acres <br />Permit 0 _ Acres <br />Affected o -Acres; <br />Mineral Ownership - <br />Mineral Private Acres <br />Surface Ownership - <br />Private Land (+/-) - _ 6 -Acres <br />Federal Land Acres <br />State Land Acres <br />Mineral State (+/-) - - ° ..- Acres <br />Mineral Federal (+/-) - - D -Acres