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.ov•co <br />a .- <br />COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />'? 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-356.7 <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 <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 sections, <br />maps, tables and/or figures, with a revised table of contents, if necessary. The revision submittal date <br />should be printed in the lower right corner of each revision page. A cover letter to the revision should <br />explain the nature of the 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 <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 modified <br />during the review process must be distributed in the same manner, along with proof of distribution. Proof <br />of distribution must be submitted prior to implementation of the revision. <br />Permit No.: C - 1980 - 007 Date: 06 / 14 / 11 <br />Permittee: Mountain Coal Company LLC <br />West Elk Mine <br />Street: P.O. Box 591 <br />City: Somerset <br />State: CO Zip Code: 81434 - 0591 <br />Brief Description of Revision: Minor Revision No. MR-376: ST-5 Escape Tunnel Fan <br />concrete protection wall <br />Public Notice Attached: Yes _ No X (Required for PRs and TRs) <br />Bond Increase: Yes _ No X Federal X Non-Federal Mine <br />Proposed Change in: <br />Permit Area - Surface Ownership - <br />Disturbed 0 0 Acres Private Land (+ /-1 0 0 Acres <br />Permit (+ /-) _ 0 0 Acres Federal Land (+/-) _ 0 0 Acres <br />Affected (+ /-) _ 0 0 Acres State Land (+ /-) _ 0 0 Acres <br />Mineral Ownership - <br />Mineral Private (+/-) _ 0 0 Acres <br />Mineral Federal (+/-) _ 0 0 Acres <br />Mineral State (+ /-) _ 0 . 0 Acres