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~� <br />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 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 - 008 Date: 09 /_14 /2018 <br />Permittee: Elk Ridge Mining and Reclamation, LLC <br />EIVED <br />Street: 27646 West 5th Street curb 2 4 2018 <br />P.O. Box 628 <br />Nucla F RECLAMATION <br />City: y �,uibiG AND SAFETY <br />State: CO Zip Code: 81424 _ <br />Brief Description of Revision <br />TR -85 removes 285.94 acres of Phase III bond <br />release area and revises the Pond 015 design. <br />Public Notice Attached: Yes ❑✓ No [](Required for PRs and TRs) <br />Bond Increase: Yes❑ No❑✓ <br />Federal ® Non -Federal✓❑ Mine <br />Proposed Change in: <br />Permit Area - <br />Surface Ownership - <br />Disturbed (+/-)-69.93 —Acres <br />Private Land (+/-) -285.94 . —Acres <br />Permit (+/-)-285.94 —Acres <br />Federal Land (+/-) 0_00 _ —Acres <br />Affected (+/-)0_00 —.—Acres <br />State Land (+/-)0.00 _ . _ Acres <br />Mineral Ownership - <br />Mineral Private (+/-) -285.94 _Acres <br />Mineral State (+/-)0.00 _ _Acres <br />Mineral Federal (+/-) 0.00 _ _ Acres <br />