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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 - 80 - 6 Date: 06 / 25 / 2012 <br />Permittee: KERR COAL COMPANY <br />Street: <br />Proposed Change in: <br />Permit Area - <br />Disturbed <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 />PO BOX 459 <br />115 EAST MAIN ST <br />FLORENCE <br />City: <br />State: CO Zip Code: 81226 <br />Brief Description of Revision: <br />Public Notice Attached: Yes❑ No <br />Bond Increase: Yes❑ No <br />MINOR REVISION: UPDATE OF COLORADO <br />DIVISION OF WATER <br />C-6 50036 <br />Fl <br />( +1 -) _ _ 0 .0 Acres <br />Permit ( +/ -) _ _ 0 Q Acres <br />Affected ( +/ -) _ _ 0 .0 Acres <br />Mineral Ownership - <br />Mineral Private (+1-) _ _ 0 0 Acres • <br />Mineral Federal ( +/ -) 0 .0 Acres <br />(Required for PRs and TRs) <br />Federal 0 Non - Federal ❑ Mine <br />REceivigo <br />JUN 2 8 20 <br />Division of Reclamation, <br />Mining and Safety <br />Surface Ownership - <br />Private Land ( +1 -) _ _ 0 . 0 Acres <br />Federal Land (+1-) _ _ 0 . 0 Acres <br />State Land ( +/ -) _ _ 0 . 0 Acres <br />0 0 <br />Mineral State ( +/ -) _ _ Acres <br />