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$ COLORADO DIVISION OF RECLAMATION MINING AND SAFETY <br />1313 Sherman Street, Room 215, Denver, Colorado 80203,'(303) 866-3567 <br />? l876 ? <br />NED <br />17 2010 <br />APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT pruning 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 maifing fist <br />(except OSM) at the same time the application is submitted to the Division, and prof 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. Prof of distribution must be submitted <br />prior to implemi of the revision. <br />Permit No.: C - 1981 - 012 Date: <br />Permhtee: New Elk Coal Company, LLC <br />New Elk Mine <br />Street 122 West First St. <br />City: Triniad <br />- <br />State: co Zip Code: 81082 <br />Brief Description of Revision: <br />Public Notice Attached: Yes - No l/ (Required for PRs and TRs) <br />Bond Increase: Yes No /-- <br />Proposed Change in: <br />Permit Area - <br />Disturbed Acres <br />Permit (+/-) - - D - Acres <br />Affected (+/-) - - U . - Ades <br />Mineral Ownership - <br />Mineral Private Acres <br />Federal Non-Federal Mine <br />Surface Ownership - <br />Private Land (+/-) U - Acres <br />Federal Land (+/-) _ _ . _ Acres <br />Stage Land (+/-) - - l? . _ Acres <br />Mineral State (+/-) v . - Acres <br />Mineral Federal (+/-) - - 0 . - Acres