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;. <br />DIVISION OF MINERALS AND GEOLOGY <br />Uepartmem of Nawral Resources <br />1313 Sherman 51., Ronm 215 <br />Denver, Cobradu 80203 <br />Phone: 13031866-7567 <br />FAX: I3D3i 832-8106 <br />OFOPERATORS <br />pi~jmr of NNaerals and GeolopY <br />TRANSFER OF PERMIT AND <br />Roy Romer <br />APPLICATIOlY FORM ~°N^a <br />' lames S. Lochhead <br />Ezeculive DIreCIOr <br />Michael 6. Long <br />Division Director <br />RECEIVED <br />MAY 31 ~ <br />The applicatior: for a Transfer of Permit and Succession of Operators must contain four (4) major parts: I) an Appliption <br />Form; 2) an Application Fee; 3) a Perfomulnce Warranty (attached as part of the Application Package) bearing the original <br />notarized signature of the Successor Operator, and, 4) a replacanent 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 />FWANCIAI. WARRANTY INFORMATION (~; <br />1. Option A: <br />(Initial & Date) <br />v <br />2. Ontion B: (~ I (f~ I 0 <br />(Initial & Date) <br />Permit#:~-1Q8.3-D(o7 Confidental?: ~ <br />Class: Type-Seq.: SO - a <br />From: To: i7rytl~ <br />Doc. Nam : S Mobile 9re~a:yCalere~2',>c--!_~_ <br />Doc. Date (if no date stamp) <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 Wananty 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 financial warranty for good cause shown, in a <br />form acceptable to the Board, within 60-days of such notice. <br />M-X483-oro7 <br />P_ttretp:P- 77b8' #tas,oo <br />STATE OF COLORADO <br />NOY= NOME <br />fly= 41~-oloa <br />