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4 ~ <br />DIVISION OF MINERALS AND GEOLOGY <br />Depamment a Natural Resources <br />7313 Sherman SL, Room 215 <br />Denver, Colorado 80203 <br />Phone (3 031 8663 56 7 <br />FAX: (303)832A106 <br />m'~98~ • a~(a- <br />ST1'~TE OF COLORADO <br />RECEIVED <br />COLORADO <br />O~I L ~ D tV It10N OF <br />~ MINF~RALS <br />GEOLOGY <br />Oisisionoflv,,,,.,,,,,,,,,-• , 6Y ~ AECtANAT,ON•NINING <br />{AfflY•{CrFNCC <br />TRANSFER OF PERMIT AND SUCCESSION OP OPERATORS wn os~: <br />Govenwr <br />APPLICATION FORM Russell George <br />Executive Diretlp <br />Ronald W. CananY <br />Division Diretlw <br />Nawnl Resource Trustee <br />77ris form hat bem {fpproved by tkt Mined Lined Reclammtion Board pursumet to sections 34--31-177, CRS, ojike Mined Lend <br />RedanealionAdand34-31.5-117, CRS, ojtkeColoradoLandReclamationAdjortkeExtraErion ofConstrudiaee Matenah Any <br />alteratlon ormodificaaion ojtku jorny 7~YoutapproroatbytkeBoardskaHresult Si Lkefurancia/wm~rmrtybeatgmrdresrdttn <br />the s»idinbf ajaery permdt isseted in cwryeenction with soda hrvaSd financial xnrranty and subject the opercRor fo cease and desist <br />ordus and civdpena@irsjor opaaNng>tdtkord o per7nitpursuant to sections 34-31-113, GRS, ojdee bfined Lined Rcclamatrio»Ad <br />and 34-31.5-IJ3, CRS., ojtlre Colorado Land Reclamation Adjor rke Emadion ojConsbuction Materials. <br />The application far a Transfer of Permit ®d Succession of Operators must caltain four (4) major parts: 1) an Application Form; 2) en <br />Application Fer, 3) a Performance Warranty (ettactted as part of the Application Package) bearing the original notarized signature of the <br />Successor Opeator; and, 4) a replacement Financial Warranty provided by the Successor Operator, bearing m original notari7xd signauue. <br />To fucpedite processing, please provide the information in the format and order described below. <br />FINANCIAL WARRANTY WFORMATION (Choose ONE Ootion): <br />1. Qptbn A: <br />(Initial & Date) <br />I wish to WAIVE MY RIGHT to s 30-day processing time to allow the <br />DIVlalnal of Mrncrals and Geology to recalculate the Financial Warranty <br />requirements. Ifyou choose Option A you should not submit a Financial Warrzmty <br />end Performance Warranty until the Division notifies you of the comet amount of <br />your warranty requuements.' <br />{Initial &. Date) <br />N~V =N(~ <br />Office a <br />Mined Land Reclanution <br />I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing time. I <br />hereby submit a replacement Financial Warranty for the same dollar amount as the <br />Financial WarranTy maintained by the current operator. I understand tbat the <br />Division of Minerals arXl Geology will recalculate the requved reclamation bond <br />within 60-days from the date that the transfer is completed end the required <br />FINANCLA?. WARRANTY COLFf~ BE SUBSTANTIALLY INCREASED at <br />that time. As the new operator, I agree to be responsible for posting any required <br />increase to the financial warranty for good cause showq in a form acceptable w the <br />Board, within 60-days of such notice. <br />Office of <br />AOive and tnaaive Mires <br />Coorado <br />Geological Survey <br />