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v <br /> Mn-_1979-191 THREE BELLS <br />STET E o~ coLO~DO <br /> <br />DIVISION OF MINERALS AND GEOLOGY _ <br />RECEl <br />'~ <br />Department ni Nawral Resources VE© ~ <br />I ~ I z Sherman sl., Roam ~ I, <br />Denver, Colorado AO?03 <br />- <br />MAY 151002 <br />Phone:13031a66-3567 <br />Pax 1303. a3z-a ~ oa Oiriston of Miner <br />l <br /> a <br />s and Geology DEPARTMENT OF <br /> I~iATUR.AL <br /> RESOURCE <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS <br /> Roy Romer <br /> APPLICATION FORM Governor <br /> lames 5. LochheaA <br /> Executive Director <br /> Michael B. Long <br /> Division Director <br />The application for a Transfer of Permit and Succession of Operators must contain four (4) major parts: 1) 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 />I. FINANCIAL WARRANTY INFORMATION (S <br />I. Option A: <br />(Initial & Date) <br />2. Option B: X 1 OL <br />(Initial & Date) <br />Permit #: Confidental7: ~_ <br />Class: Type-Seq.:SD-~_ <br />From: ~ (t;~s.~r~c To: ~CVIG- <br />Doc. Nam :S u9 tYt nbrtZ,e~.~..,~ ~n I -~ -- r•'b.I- <br />Doc. Date (if no date stamp):.S! t <br />I wish to WAIVE MY RIGHT to a 30-day processing time to allow <br />the Division of Minerals and Geology to recalculate the Financial <br />Warranty requirements. <br />I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing <br />time, I hereby submit 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 SUI~TANTIALLY INCREASED at that <br />time. As the new operator, I agree to be responsible for posting any <br />required increase to the financial wamdnty for good cause shown, in a <br />form acceptable to the Boazd, within 60-days of such notice. <br />i~OV= N oN'~ <br />