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Aug 30 11 04:58p Savage and Savage 970 674 8088 p.2 <br />r,^ , li <br />COLORADO DIVISION OF RECLAMATION, MDUNG AND SAFETY <br />`•` 1313 Sherman Street, Room 215, Deaver, 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 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 - 92 - 80 Date: 08 /30 12011 <br />permigee: Oakridge Energy, Inc. <br />Street: 4613 Jacksboro Hwy. <br />City: Wichita Falls <br />State: TX Zip Code: 76302 _ <br />Brief Description of Revision: Construction of incidental access road on landowners <br />property unrelated to coal mining. <br />Public Notice Attached: Yes❑ No (Required for PRs and TRs) <br />Bond Increase: Yes❑ NoE✓ Federal ❑ Non - Federal 0 Mine <br />Proposed Change in: <br />Permit Area - <br />Disturbed ( + / -)0 _ _._Acres <br />Permit ( +/ -)0 _ . —Acres <br />Affected ( + 1-)0 _ _ . —Acres <br />Mineral Ownership - <br />Mineral Private ( +l -) 0. Acres <br />Mineral Federal ( + / -) 0 _ _ —Acres <br />Surface Ownership - <br />Private Land ( +/ -) 0 _ _ , —Acres <br />Federal Land ( + / - -) 0 _ . _ _ Acres <br />State Land (+/-)o _ _ r Acres <br />Mineral State ( + / -) 0 _ _ . —Acres <br />