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$ COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />?a876? ww <br />APPLICATION FORM FOR A REVISION FEB 0 /609 <br />TO A COAL MINING AND RECLAMATION PERMIT Division of Reclamation, <br />Mining and Safety <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 nratiing 19 <br />(e)cept OSM) at the same time the application is submitted to the Division, and proof of motion must be <br />submitted to the Division along with the application. Copies of revision pages mix1ified 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 - 81 - 012 Date: 0/ / '30 / 017 <br />Permit: New Elk Coal Company <br />New Elk 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 - (Required for PRs and TRs) <br />Bond Increase: Yes X No_ <br />Proposed Change in: <br />Permit Area - <br />Disturbed (+/-) - - Z . © Acres <br />Permit (+/-) ?_. Q Acres <br />Affected (+/-) - - - - Acres <br />Mineral Ownership - <br />Mineral Private Acres <br />Federal - Non-Federal X_ Mine <br />Surface Ownership - <br />Private Land (+/-) - - - - Acres <br />Federal Land Acres <br />State Land (+!-) G . f7 Acres <br />Mineral State (+/-) I f L. 0 Acres <br />Mineral Federal (+/-) - - - . - Acres <br />M AIF- w F -Ur wi-t-