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oe'C <br />tee. <br />COLORADO DIVISION OF MINERALS AND GEOLOGYMCMVM <br />'`?e,s • r 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />AVG T 8.20 }p--. <br />APPLICATION FORM FOR A REVISION "? awd ? e. <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 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 - 022 Date: August / 13 / 2010 <br />Permittee: Oxbow Minin , LLC. <br />Elk Creek Mine <br />Street: 3737 State Highway 133 <br />P.O. Box 535 <br />City: Somerset <br />State: Co. Zip Code: 81434 _ <br />Brief Description of Revision: MR - 91- Borehole Abandonment Information <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 - Surface Ownership - <br />Disturbed o _ Acres Private Land Acres <br />Permit Acres Federal Land 0 Acres <br />Affected 0. _ Acres State Land 0 Acres <br />Mineral Ownership - <br />Mineral Private 0 .-Acres; Mineral State 0 - Acres <br />Mineral Federal 0 -Acres