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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 o%ej*4 0 <br />RE <br />AEG 2l 201 <br />APPLICATION FORM FOR A REVISION pF RECIA ' � <br />TO A COAL MINING AND RECLAMATION PERMIT S*EV <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). Al 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 />Al 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 lancer right comer 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 - 035 Date: 08 / 19 / 2013 <br />Penn ittee: GCC Energy, LLC <br />Street: 6473 County Road 120 <br />City: Hesperus <br />State: CO Zip Code: 81326 <br />Brief Description of Revision: Technical Revision 21: Exploration core <br />drilling program on Colorado Coal Lease <br />CO -3388. <br />Public Notice Attached: Yes _ No X (Required for PRs and TRs) <br />Bond Increase: Yes _ No X Federal Non - Federal _ Mine <br />Proposed Change in: <br />Penn it Area - <br />Surface <br />Ownership - <br />Disturbed ( + / -) _ _ <br />0 . Q Acres <br />Private Land <br />( + / -) _ <br />_ 0 . 0 Acres <br />Permit ( + / -) _ _ <br />0 0 Acres <br />Federal Land <br />( + / -) _ <br />_ 0 0 Acres <br />Affected ( + / -) _ _ <br />0 . o Acres <br />State Land <br />( + / -) _ <br />_ o 0 Acres <br />Mineral Ownership - <br />Mineral Private ( + / -) <br />_ _ .o . 0 Acres <br />Mineral State <br />( + / -) _ <br />_ 0 .0 Acres <br />Mineral Federal ( + / -) _ _ 0. 0 Acres <br />