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10-09-07;12:47PM; <br />;970 241 1516 # 4/ 5 <br />-M23 <br />Gypz 5toC-TAJ <br />'? . COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY i015167 <br />' 1313 Sherman Stxeet, 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 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 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 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 />Pe ttStreet: <br /> <br />City: <br />Munger Canyon Mine <br />P.O. Box 98 <br />Loma <br />State: co Zip Code: 81524 <br />Brief Description of Revision: Proposed revision will Incorporate figures 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 (f!-) „_ ,? tl . 3 Acres <br />Permit No.: C - 1981 - 020 Date: 10 / 04 2007 <br />rmi ee: CAM Minina LLC <br />Permit (*!-) - - _.L Acres <br />Affected -+1 . 3 Acres <br />Mineral Ownership - <br />Mineral Private (+/-) - - 0 , Acres <br />Surface Ownership - <br />Primate Land Acres <br />Federal Land (*/-} u 3 .3 Acres <br />State Land (+/-) - - a . 3 Acres <br />Mineral State (+/--) Acres <br />Mineral Federal (+/-) - - 0 . 0 Acres