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STATE OF CO~,OlZ~DO <br />DIVISION OF A~iiNERALS ANO GEOLOGY <br />Department of Natural Resources <br />1313 Sherman St, Room 215 C O L D RA D O <br />Denver, Colorado 80203 ~ ~... G I (, ,~ } D t v t S t o N o f <br />Phone: (303) 8663567 M I N E&,RA L S <br />FAX: (303) 832-8106 ~ --"'~ ~ ~ ~ ~ G E O L O G Y <br />/~~ // _~~~'~~~ C(_^IYn l ~ / RECLAM ATION•NINING <br />~(Iri'/ i~./l//. /U' ~c'1,V ~/ SA FETT•SQENCE <br />TRAA'5FER OF PERMIT AND SIICCESSION OF OPERATORS gal Owens <br />APPLICATION FORM / Governor <br />Greg E. Walther <br />ExeMive Director <br />Ronald W. Cadany <br />Division Director <br />Natural Resource Trustee <br />The applicationfor a Transfer ofPermit and Suceession of Operators must eontam four (4) major pads: i) anApp]icatienForm; 2) an <br />Application Fee; 3) a Performance Warranty (attached as part ofthe ApplicationPaokage) bearing the originalnotatizedsigoanse ofthe <br />Successor Operator, and, 4) a replacemeat Financial Warranty provided by the Successor Operator, bearing an original notarized <br />signattae. To expedite processing, please provide the information in the format and order described below. <br />I. FINANCIAL WARRANTY INFORMATION {Choose ONE Opton): <br />1.0otion A: I wish to WAIVE MY RIGHT to a 30-day processing time to allow the <br />(Initial 8c Date) Division of Minerals and Geology to recalculate the Financial Warraniy- <br />requirements. If you choose Option A you should not submit a Financial. <br />Warranty and Perfatmaaoe Warranty until the Division notifies you of the <br />,.....n..r a...ouat_of ye . <br />2.OutionB:10 01 2004 <br />(Initial & Date) <br />I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing time. I <br />hereby submit a replacement Financial Warranty forthe same dollar amount as <br />the Financial Warrantymaintainedbytheturrent operator. Itmdetstandthatthe <br />Division of Ivimerals and Geology will recalculate the required reclamation <br />bond within 60-days from the date that the transfer is completed and the <br />required FINANCIAL WARRANTY COULD BE SUBSTANTIALLY <br />INCREASID at that time. As the new operator, I agree to be responsible for <br />posting any required incense to the financial warrantyfor good cause slwwn, in <br />a form acceptable to the Board, within 60-days of such notice. <br />Nv V- ~nN~ <br />~ ~ l~~ -~ all t G /zoos <br />Office of Office of Colorado <br />Mined Land Reclamation Active and Inactive Mines Geological Survey <br />