2007-08-30_REVISION - M1984041

• Permit No: M1984041
• IBM Index Class Name: Revision
• Doc Date: 8/30/2007
• Doc Name: Application form
• From: American Gypsum Company
• To: DRMS
• Type & Sequence: SO4
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
1313 Sherman St., Room 215
Denver, Colorado 80203 ~:~ ~, `~~`. E (d~® C O L O RA D O
3 11 D I V I S I O N O F
Phone: [phone] RECLAMATION
FAX: 13o3)a3z~t06 ~'I~~~ ~^~'/ Q(J~~ ZO MINING
Division of q4 SAFETY
~" N"fining and Sa ety0v
~ ^ -o~~ /1 ~ !, ns'~ M C~ ~ ff r(/1" / / /~ ,/' Bill Ritter, )r.
'~i~ _ /f't-'y'y/I(A ' ~ / `Y f l w~- ~ Governor
i t 'PRANSFER OF PERMIT AND SUCCESSION OF OPERATORS Harris D. Sherman
/ Executive Director
APPLICATION FORM L/ Ronald w. Gnany
Division Director
Natural Resource Trustee
~~4"
The application for a Transfer of Permit and Succession of Operators must contain fora (4) major parts: 1) anApplication Form; 2)
an Application Fee; 3) a Pefformance Warranty (attached as pact of the Application Package) bearing the original notarized
signature of the Successor Operator; and, 4) a replacement Financial Warranty provided by the Successor Operator; bearing an
original ~tarized signature. To expedite processing, please provide the information in the foment and order described below,
[. FINANCIAL WARRANTY INFORMATION (Choose ONE ODtion):
1.ODtion A:
(Initial & Date)
I wish to W Al V E MY RIGHT m a 30<lay processing tithe to allow the
Division of Reclamation, Mining arld Safety to malculate the Financial
2. ODdon B: ~ ~~~~
(Initial & Date)
Office of
Mined Land Reclamation
Warranty requirements. If you choose Option A you should not submit a
Financial Warranty arld Perfortrtattce Warranty until the Division tmdfies you
of the correct amount of your waraanty tequiretants.•
[ DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing time. I
hereby submit a replacement Financial Warranty for the same dollar amount
as the Fitancial Wartenty t~inmmed by the current operator. I understand
that the Division of Reelamarion, Mining and Safety will recalculate the
required reclamation bond within GO-days from the date that the trensfer fie
cotrlpleoed and the required FINANCIAL WARRANTY COULD BE
SUBSTANTIALLY INCREASEp at That time. As the new operator, I agree
to be responsible for posting any required increase to the financial warranty
for good cause shown, in a fomr acceptable to the Board, within 60-days of
such notice.
Office of
Active and Inactive Mines