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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- 1981 - 028 Date: November 9, 2012 <br />Permittee: Coors Energy Company <br />Street: P.O. Box 467 <br />City: Golden <br />State: Colorado <br />COLORADO DIVISION OF MINERALS AND GEOLOGY <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 Division of <br />Zip Code: 80402 <br />Brief Description of Revision : Revision of vegetation cover and herbaceous production <br />revegetation success criteria. <br />Public Notice Attached: Yes X No (Required for PRs and TRs) <br />Bond Increase: Yes No X Federal Non - Federal X Mine <br />NOV <br />Mining & Saiety <br />Proposed Change in: <br />Disturbed Area ( + / -) 0.0 acres Acres Affected Area ( + / -) 0.0 acres Acres <br />Permit Area (+ / -) 0.0 acres Acres Federal Land (+ / -) 0.0 acres Acres <br />State Land (+ / -) 0.0 acres Acres Private Land (+ / -) 0.0 acres Acres <br />