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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 />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_ 2,010 - 89 Date: 05 /14 /2013 <br />Permittee: Western Fuels- Colorado, A Limited Liability Company <br />Street: 12050 N. Pecos Street RECEIVED <br />Suite 100 <br />City: Westminster MAY 16 2013 <br />State: CO Zip Code: 80234 _ Division of Reclamation, <br />Mining & Safety <br />Brief Description of Revision: Submittal of the CDPHE, Air Pollution Control <br />Division, Compliance Order on Consent (COOC) to <br />inclusive of overburden drilling and blasting_ This <br />revision is for insertion into Appendix 2.05.6(1). <br />Mineral Ownership - <br />Mineral Private ( + / -) _ N/A _Acres Mineral State ( + / -) _ N/A —Acres <br />Mineral Federal ( + / -) _ N/A _ Acres <br />Public Notice Attached: Yes❑ <br />No <br />❑✓ <br />(Required for PRs and TRs) <br />Bond Increase: <br />Yes❑ No F7 <br />Federal F Non - Federal ❑✓ Mine <br />Proposed Change in: <br />Permit Area - <br />Surface Ownership - <br />Disturbed <br />( + / -) _ N/A <br />_ Acres Private Land ( + / -) _ N/A _ Acres <br />Permit <br />( + / -) _ N/A <br />_ Acres Federal Land ( + / -) _ N/A _ Acres <br />Affected <br />( + / -) _ N/A <br />_ Acres State Land ( + / -) _ N/A _ Acres <br />Mineral Ownership - <br />Mineral Private ( + / -) _ N/A _Acres Mineral State ( + / -) _ N/A —Acres <br />Mineral Federal ( + / -) _ N/A _ Acres <br />