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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 Sherman Street, 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 <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: 10 / 19 / 11 <br />Permittee: Mountain Coal Company, LLC <br />Street: <br />City: <br />State: <br />West Elk Mine <br />P.O. Box 591 <br />Somerset <br />CO <br />Brief Description of Revision: <br />Proposed Change in: <br />Permit Area - <br />Disturbed (+ / -) 0 . 0 Acres <br />Permit (+ / -) _ 0 . 0 Acres <br />Affected (+ 1 -) 0 . 0 Acres <br />Mineral Ownership - <br />Mineral Private ( +1 -) 0 . 0 Acres <br />Mineral Federal ( +1 -) 0 . 0 Acres <br />Zip Code: 81434 - 0591 <br />Minor Revision No. MR -382: Addition of MDWs E3 -61 <br />and E3 -64. <br />Public Notice Attached: Yes _ No X (Required for PRs and TRs) <br />Bond Increase: Yes — No X Federal X Non - Federal Mine <br />Surface Ownership - <br />Private Land (+ / -) _ 0 . 0 Acres <br />Federal Land (+ / -) _ 0 . 0 Acres <br />State Land (+ / -) _ 0 . 0 Acres <br />Mineral State (+ / -) 0 . 0 Acres <br />