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!O ~ ~a~4 r1 n 4 (i~'6 n7Cr ~ ~H,'t~W. ~1t,'C ~ ~ W ~4~p, /`LNr/1 pF C0 ~~~~~~~ COLORADO DIVISION OF MINERALS AND GEOLOGY ll 11 19 I6 ~ ';°~'• 1313 Sherman Street, itootn 215, Denver, Colorado 80203, (303) 866-356 III IIIIIIIIIIIII'll 999 APPLICATION FORM FOR A REVISION TO A COAL MINING AND RECLAMATION PERMIT This form must be completed and submitted with all requests for minor revisions, as defined in Rule 1.04(731, technical revisions, as defined in Rule 1.0411361, and permit revisions, as defined in Rule 1.04(901. All revisions are to address the requirements of Rule 2.08.4. Three (3) copies of the revision, including maps, must be submitted in order for it to be complete. All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, tables andlor figures, with a revised table of contents, if necessary. The revision submittal date should be printed in the lower right corner of each revision page. A cover letter to the revision should explain the nature of the revision and reference the specific permit sections being revised. For federal mines, a copy of the revision application must be submitted to all agencies on the federal mailing list (except OSMI at the same time the application is submitted to the Division, and proof of distribution must be submitted to the Division along with the application. Copies of revision pages modified during the review process must be distributed in the same manner, along with proof of distribution. Proof of distribution must be submitted prior to implementation of the revision. f1U"JGER CANYOPJ f~1IPJE Permit No.: C - ~_ - 020 Date: ( / ~ / Permittee: GRAiVn VALLEY COAL COMPANY Street: P fl R'1X 7N City: L'J~'!'a State: CO zip mode: 81521 _ 0070 Brief Description of Revision: ~V/S~ l~L1FL ~~~Ql!»"l~ Public Notice Attached: Yes _ No.~ (Required for PRs and TRs/ Bond Increase: Yes _ No ~( Federal ~' Non-Federal _ Mine Proposed Change in: Disturbed Area (+/-) ~ . Acres Affected Area (+/-) ~ . Acres Permit Area (+/-I _ _ Q . _ Acres Federal Land (+/-) _ _ Q. _ Acres State Land (+/-) _ _ ~ - _ Acres Private Land (+/-) _ _ ~ . _ Acres