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Fram~. Cirl~n~ m~~l-c{ra~s coiP>/ <br />D4YISlON OF MINERALS AND GEOLOGY <br />Depanment of Natural Resources <br />7313 Sherman Se., Room 273 <br />Denver, Colorado 80203 <br />Phone: 1303) Bb6-3567 <br />fAX: (3031 032-87 06 <br />~'~/ <br />(111'13`- Le <br />STATE OF COLOI?.ADO <br />M ~~~~~~' <br />O'y: •n qy ~ 4CO„ <br />~0 ~t vA <br />TRANSFER OF PERMIT AND SUCCESSION~F~~PER~TORS <br />APPLICATION FORM ,/ d?d ~B%~ <br />D I V I S I O N <br />MINER.A <br />&- <br />GEOLOC <br />RE~C LA MATI <br />MINING•SA Cp <br />gill Owens . <br />Governor <br />Greg E. Walther <br />rxecwive Director <br />Mi<haet 8. Long <br />Division DireUOr <br />The application for a Transfer of Permit and Succession of Operators must contain four (4) major parts: I) an Application <br />Form; 2) an Application Fee; 3) a Performance Warranty (attached as part of the Application Package) bearing the original <br />notarized signature of the Successor Operator; and, 4) a replacement Financial Warranty provided by the Successor <br />Operator, bearing an original notarized signature. To expedite processing, please provide the information in the format <br />and order described below. <br />FINANCIAL W ARRANLY INFORMATION (Choose ONE Option): <br />I. tion A: I wish to WAIVE MY RIGHT to a 30-day processing time to allow <br />(Initial & Date) the Division of Minerals and Geology to recalculate the Financial <br />Warranty requirements. If you choose Option A you should not submit <br />a Financial Warranty and Performance Warranty until the Division <br />notifies you of the correct amount of your warranty requirements.* <br />2 n B: S oS-O\•V31 DO NOT WISH TO WANE MY RIGHT to a 30-day processing <br />( r tal & Date) time. I hereby subnut a replacement Financial Warranty for the same <br />' dollar amount as the Financial Warranty maintained by the current <br />operator, I understand that the Division of Minerals and Geology will . <br />recalculate the required reclamation bond within 60-days from the date <br />that the transfer is completed and the required FINANCIAL <br />WARRANTY COULD BE SUBSTANTIALLY INCREASED at that <br />time. As the new operator, I agree to be responsible for posting any <br />required increase to the fmar_ia] warranty for good cause shown. in a <br />form acceptable to the Eoard, within 60-days of such notice. <br />r~av = rn~ ~aa~ 02$ <br />pr-~ _ ~ ~ 22~ t~3 <br />