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oF.co? <br />y 8 COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />* 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 vr_GF ED <br />APPLICATION FORM FOR A REVISION g )R "Z 0Wl <br />TO A COAL MINING AND RECLAMATION PERMIT <br />. ;:eciamaiian, <br />a,?r? 52EQ? <br />This form must be completed and submitted with all requests for minor revisions, as defiAWUVule <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 <br />sections, maps, tables and/or figures, with a revised table of contents, if necessary. The revision <br />submittal date should be printed in the lower right corner of each revision page. A cover letter to the <br />revision should explain the nature of the revision and reference the specific permit sections being <br />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 <br />modified during the review process must be distributed in the same manner, along with proof of <br />distribution. Proof of distribution must be submitted prior to implementation of the revision. <br />Permit No.: <br />Permittee: <br />C - 2009 - 087 Date: 4 is 2011 <br />Peabody Sage Creek Mine <br />Street: 36600 Routt County Road 27 <br />City: Hayden <br />State: CO Zip Code: 81639 - <br />Brief Description of Revision: TR02-11, Hydrology Monitoring Plan Changes <br />Public Notice Attached: Yes x No (Required for PRs and TRs) <br />Bond Increase: Yes No X Federal X Non-Federal Mine <br />Proposed Change in: <br />Permit Area Mineral Surface <br /> Ownership Ownership <br />Disturbed (+/-) 0 0 Acre Private (+/-) 0 0 Acres Private (+/-) 0 0 Acres <br /> s <br />Permit (+/-) 0 0 Acre Federal (+/-) 0 0 Acres Federal (+/-) 0 0 Acres <br /> s <br />Affected (+/-) 0 0 Acre State (+/-) 0 0 Acres State (+/-) 0 0 Acres <br /> s <br />"_ ---A