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* oFco? * <br />COLORADO DIVISION OF RECLAMATION' MINING AND SAFETY <br />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 <br />1.04(73), technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule <br />1.04(90). All revisions are to address the requirements of Rule 2.08.4. Three (3) copies of the revision, <br />including maps, must be 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, <br />maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal date <br />should be printed in the lower right corner of each revision page. A cover letter to the revision should <br />explain the nature of the 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 <br />mailing list (except OSM) at the same time the application is submitted to the Division, and proof of <br />distribution must be submitted to the Division along with the application. Copies of revision pages modified <br />during the review process must be distributed in the same manner, along with proof of distribution. Proof <br />of distribution must be submitted prior to implementation of the revision. <br />Permit No.: C - 80 - 007 Date: 04 / 28 <br />09 <br />Permittee: Mountain Coal Company LLC, West Elk Mine <br />Street: P.O. Box 591 <br />City: Somerset <br />State: CO Zip Code: 81434 - <br />Brief Description of Revision: Technical Revision No. 117, Update of Permit No. C-80- <br />007, in response to CDRMS Mid-term Review No. 6 (MT-6) <br />Public Notice Attached: Yes X No <br />Bond increase: Yes No _X <br />Proposed Change in: <br />Permit Area - <br />Disturbed (+ 0 <br />Acres <br />(Required for PRs and TRs) <br />Federal X Non-Federal Mine <br />Surface Ownership - <br />Acres Private Land 0 <br />Permit (+ /-) 0 Acres <br />Acres <br />Affected (+ l-) 0 Acres <br />Acres <br />Federal Land (+ /-) <br />State Land ( + /-) <br />0 <br />0