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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 Sherman Street. Room 215. Denver, Colorado 80203. (303) 4IVE` <br />APPLICATION FORM <br />RENEWAL OF A VALID, EXISTING PERMIT <br />TO CONDUCT MINING IN COLORADO <br />NOV 1 3 20',2 <br />Division of Reclam ?IT. <br />Mining & Safety <br />This form is an application for successive renewal of a valid, existing permit to conduct surface or <br />underground mining and reclamation activities or other surface coal mining and reclamation <br />operations in Colorado pursuant to C.R.S. 34 -33 -101, et seq. This application form is designed to <br />revise and update the application form currently included in your permit application. The right of <br />successive renewal applies only to lands and activity which were permitted during the previous <br />term. Extensions of the permit area and significant new activity within the permit area are subject <br />to the review procedures applicable to new permit applications, in accordance with Rule <br />2.08.5(1)(c) and 2.08.4. <br />For a renewal application to be deemed complete by the Division pursuant to C.R.S. 34 -33- <br />109(7), an applicant must submit: (1) all information as specified on this application form; (2) a <br />copy of the newspaper notice; (3) evidence that a liability insurance policy will be provided for the <br />proposed period of renewal; and (4) five reproducible copies of the permit renewal application <br />with original signatures <br />For federal mines, a copy of the renewal application must be submitted to all agencies on the <br />federal agency mailing list at the same time the application is submitted to the Division, and proof <br />of distribution must be submitted to the Division. Copies of renewal pages modified during the <br />review process must be distributed in the same manner, along with proof of distribution. Proof of <br />distribution must be submitted prior to implementation of the renewal. <br />GENERAL OPERATION INFORMATION <br />Type or print clearly the appropriate information as listed below. Supplemental sheets may be used as <br />necessary. Such sheets must be attached to the form and refeenced or keyed to the numbers on the <br />form. <br />1. Permittee: Western Fuels- Colorado, A Limited Liability Company <br />2. Name of Operation: New Horizon Mine <br />3. Permit Number (same as current permit number): C -81 -008 <br />4. Type of Revision: RN Renewal Number: 6 <br />5. Application Submittal Date: October 29, 2012 <br />6. Correspondence Information <br />APPLICANT /OPERATOR (Name, Address and Phone of Name to be used on Permit) <br />Individual's Name: Lance Wade <br />R \WESTERN FUELS - COLORADO \NEW HORIZON \2012 NHM PERMIT RENEWAL FORM FINAL 310CT12 V1 DOCX <br />