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STATE OF COLORADO <br />DIVISION Of MINERALS AND GEOLOGY <br />DepaMrmtdlJaturdlteaoraLrs ~ RECEIVED <br />1313 Shemwr Sr., Room 2t 9 C O L O RAD O <br />Derrvv, C.OIORdO 80203 DIVISION O ! <br />l'horrc (30318663567 DEC 012005 MIN RA L S <br />FAX: 1303) 832-0106 G E O L O G Y <br /> <br />Ofvfaisn of Minerals and Geslogy !lCLaNaT10N•NINING <br />swrlrT•rcrlNC! <br /> BIII Owen <br /> TRANSFER OF P&RNIIT AND SUCC&SffiON OF OPSRATOR9 GO1v10f <br /> APPLICATION FORM r6me11 G°01B' <br /> tNN.Vare Dircaor <br /> Rudd W. Caaairy <br /> Division DlnNmr <br /> Ni1va1 RuoiNx Trusrse <br />The apptiatim far a TraneferofPamit and Sac~ian ofOperator must odlhiD Coar(4) mycrputs: 1) m AppHcatimFar~ 2) <br />m Appliatiaa Fee; 3) a Pt:famimce Watraay (atalchtd a put of the Appliatiou Package) beating the original mprized <br />ai~atue of the Saccemar Opermr; and, 4) a replaoemeat FmmcLl Wamoty plavided by the S~rcaasa Opetatnr, bearing m <br />atigmal notarised eigoadu~e. To expedioe ptoot~, please provide the iafsrmatian m the fotntat and order Abed below. <br />L FINANCIAL WARRANTY EIIFORMATION (Choose ON& OotionY. <br />1.Oolioo A: I wish to WAIVE MY RIGHT to a 34day plooesaDg time m allow the <br />(Initial & Dak) Divieiata of MircasL and Geology m recakvLte the Fiamcial Warranty <br />requucDeu~ >f you dlooee OpdaD A yaa should Q41 aubntit a Fmmcial <br />Wamaty and Paformaooe Wartaoty nodl the Divie;on ratifies yaa of the <br />correct uoomt of yoo<warrnty reglmmeats.' <br />1.O~B: I DO Nt7f WISH TO WAIVE MY RIGHT k a 30-day proaeamg time. I <br />(hritisl 8t i)ak) hereby sablnit a rephlcemem Fimocial Warramy fa the same dollar amotmt <br />as the Fmmcial Wutmry maintainM by the cturent operator. I Indastaod <br />that ~e Division of Minerals aad Geoogy wHl recaktllate the tequued <br />rechmatim bond within 60-days fromthe dsBe that the trnefer ie completed <br />sod the rerllti.ed FINANCIA[. WARRANTY COULD BE <br />SUBSTANTIAILYIN(]tEASEDatthstt®e. Astlneaewoperoor,Iagree <br />to be reapomlbk forpaaliog my regtmedmclease to the fmmciel warrmty <br />for good cease shown, m a fain atxephbk k the Bond, within to-days of <br />such entice. <br />Nd ~ _ ,~s~ <br />~~l~~ ~e vs ~n <br />OM"ice d <br />Mined lard Reclamation <br />OMice d <br />AANe and Inanive Mines <br />Colorado <br />Geological Survey <br />