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COLORADO DIVISION OF RECLAMATION, MINING AND SAFET'd <br />1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866 -3567 �� <br />CO <br />ciC <br />o <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 8 Date: 10 / 10 / 2012 <br />Permittee: Western Fuels- Colorado <br />Street: <br />City: <br />State: <br />P.O. Box 628 <br />27646 W. 5th Ave <br />Nucla <br />Bond Increase: YesE No <br />CO Zip Code: 81424 <br />Brief Description of Revision: Revision of prime farmland determination and related <br />soil redistribution and revegetation plans. <br />Replacement of Irrigated Cropland technical <br />standard with a reference area. See attached cover <br />letter for more information. <br />Public Notice Attached: Yes <br />0 <br />Fl <br />Proposed Change in: <br />Permit Area - <br />Disturbed ( + / -)0 _ _ _ Acres <br />Permit ( + / -)O _ _ _ Acres <br />Affected ( + / -)0 _ _ _ Acres <br />Mineral Ownership - <br />Mineral Private (+1-) ° _ . _Acres <br />Mineral Federal ( +/ -) 0 _ Acres <br />No F1 ( Re q uired for PRs and TRs) <br />Federal E Non - Federal Fl Mine <br />Surface Ownership - <br />Private Land (+00 _ _ _ Acres <br />Federal Land ( +/ -) 0 _ _ _ Acres <br />State Land <br />(+1-) 0 _ _ . _ Acres <br />Mineral State (+1-) 0 _ . _ Acres <br />