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09-22-D6 01:43PM FROM-DMG GRAND JUNCTION FIELD OFFICE 970 241 1516 T-154 P.D02/007 F-944 <br />PCn <br />"~ 'e' C©Y.ORADO DIVISYON OF MINERALS AND GEOLOGY ~'(Q-~jq <br />•~~` ]3]3 Sberman Streer, Room?15, Denver, Coiorado 80203, (303) 866-3567 <br />APPLICATION FORM FOR A REVISION <br />TO A GOAL 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 apmplete, <br />All revisions are to be formatted so they can be inserted into the permit to replace the revised sections, maps, <br />tables andlor figures, with a revised table of contents, 'rf 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 distribu#ion must be <br />submitted to the Division along with the application. Copies of revision pages modified during the review process <br />must be distrbuted 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 />C - 1980 - 004 <br />CAM MINING LLC <br />Date: 08 / 14 / 2006 <br />Permittee: <br />Street: <br />McClane Canyon Mine <br />P.O, Box 98 <br />city: Loma <br />State: CO Zip Code: 81524 _ <br />Brief Description of Revision: Change resident agent and inspection contact listed <br />in Appendix A. <br />Public Notice Attached: Yes _ No /_ (Required forPRs and TRs) <br />Bond Increase: Yes _ No r! Federal ~ Non-Federal _ Mine <br />Proposed Change in: <br />Permit Area - <br />Disturbed (+/-), 0 . 0 Acres <br />Permit (+f-) _ _ 0 . 0 Acres <br />Affected (+/_) _ _ 0 , 0 Acres <br />Mineral Ownership - <br />Mineral Private (+/-) J _ 0 , 0 Acres <br />Mineral Federal (+!-) ~ _ 0 . 0 Acres <br />Surface Ownership - <br />Private Land (+!-) _, _ 0 . 0 Acres <br />Fetleral Land (+/-} _, ~ 0 . 0 Acres <br />State Land (+!-) _ _ 0 . ~ Acres <br />Mineral State (+/-) _ _ ~ ~ Acres <br />