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NOTARY FOR PROSPECTIVE SUCCESSOR <br />STATE OF <br />) ss.: <br />COUNTY OF <br />The foregoing instrument was acknowledged before me this day of <br />by as of <br />Notary Public <br />My Commission Expires <br />STATE APPROVAL <br />[for completion by Division] <br />(a) The Board hereby approves the transfer of permit number (āœ“1 I c G! 7 OU -5- from <br />fp 7- Or, i to Lā€” <br />(b) <br />(b) The Board hereby recognizes as Successor Operator under <br />such Permit. <br />(c) The Board hereby accepts the Performance and Financial Warranties submitted by Successor and hereby <br />releases , as former Permittee from all obligations under <br />its Performance and Financial Warranties. The Board further releases all affected financial warrantors from <br />obligations under Financial Warranties associated with the former Permittee. <br />STATE OF COLORADO <br />DEPARTMENT OF NATURAL RESOURCES <br />MINED LAND RECLAMATION BOARD <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />By: Date Executed: <br />Division Director <br />- 10 - <br />