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? pF•G <br />COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-356' ,i EC <br />EKED <br />APPLICATION FORM FOR A REVISION Division of Recta n, <br />TO A COAL MINING AND RECLAMATION PERMIT Hningand8ft <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 - 1981 _ 020 Date: 10 / 04 / 2007 <br />Permittee• CAM Mininq LLC <br />Street: <br />City: <br />State: <br />Munqer Canyon Mine <br />P.O. Box 98 <br />Loma <br />CO Zip Code: 81524 _ <br />Brief Description of Revision: Proposed revision will incorporate fiqures that show the as-built <br />reclamation contours and cross sections into the permit. <br />Public Notice Attached: Yes ? No _ (Required for PRs and TRs) <br />Bond Increase: Yes _ No ? Federal ? Non-Federal - Mine <br />Proposed Change in: <br />Permit Area - <br />Disturbed _+1 . 3 Acres <br />Permit 0 . 0 Acres <br />Affected _+1 3 Acres <br />Mineral Ownership - <br />Mineral Private 0 Acres <br />Mineral Federal 0 . 0 Acres <br />Surface Ownership - <br />Private Land 0 0 Acres <br />Federal Land 0 . 0 Acres <br />State Land 0 , 0 Acres <br />Mineral State (+/-) 0 . 0 Acres