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A_N__ 0 A _ %k' <br />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 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 corner 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 — 81 — 010 <br />Date: 3 / 26 / 2012 <br />Permittee: Trapper Mining Inc. <br />Street: PO Box 187 <br />City: <br />State <br />Craig <br />CO ZIP Code 81626 - <br />Brief Description of Revision: TR 109, 2011 Annual Reclamation Report <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 — <br />Disturbed ( + / -) _ _ _ _ Acres <br />Permit ( + / -) _ _ _ _ Acres <br />Affected ( + / -) _ _ _ . _ Acres <br />Mineral Ownership — <br />Mineral Private ( + / -) _ _ _ _ Acres <br />Mineral Federal ( + / -) _ _ _ _ Acres <br />Surface Ownership — <br />Private Land <br />( + / -) _ _ <br />_ _ Acres <br />Federal Land <br />( + / -) _ _ <br />_ _ Acres <br />State Land <br />( + / -) _ _ <br />_ _ Acres <br />Mineral State <br />( + / -) _ _ <br />_ _ Acres <br />