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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.: <br />Permittee: <br />Street: <br />COLORADO DIVISION OF RECLAMATION, MINING AND SAF!CEIVED <br />1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866 -3567 • <br />F2 6,,013 <br />C_ 1,981 _ 12 <br />New Elk Coal Company, LLC <br />New Elk Mine <br />12250 Highway 12 <br />Weston <br />City: <br />State: CO Zip Code: 81091 <br />Brief Description of Revision: <br />Public Notice Attached: Yes® No <br />Bond Increase: Yes fl Non <br />Proposed Change in: <br />Permit Area - <br />Disturbed <br />APPLICATION FORM FOR A REVISION <br />TO A COAL MINING AND RECLAMATION PERMIT <br />Add a 1,280 square foot (21' x62') addition to the <br />existing employee bathhouse to provide additional <br />3pol.0 [u d Icage' VI Idt Iyt I UUI I I. <br />(+0° _ _ . _ Acres <br />Permit ( +/ -)0 _ _ _ Acres <br />Affected ( +00 _ Acres <br />Mineral Ownership - <br />Mineral Private ( + / -) • _Acres <br />Mineral Federal ( + / -) 0 _ _ _ Acres <br />Date: 02 / 26 / 2013 <br />(Required for PRs and TRs) <br />Federal El Non - Federal ® Mine <br />Division of Reclamation, <br />Mining & Safety <br />Surface Ownership - <br />Private Land ( + / -) 0 _ Acres <br />Federal Land ( +/ -) 0 _ _ _ Acres <br />State Land ( + / -) 0 _ _ _ Acres <br />Mineral State ( + / - 0 _ _ _ Acres <br />