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STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department of Natural Resources RE <br />CEI~/ED <br />1.713 Sherman St., Ronm ? 1 i , <br />Denver, ColoraAo 80203 <br />Phone: 13031 8663567 111\I O 7 AfYM <br />JVI, GWL <br />FAX: 13U3i B7Z-8106 <br />Division of Mineras end GeatB9Y <br />R~E~Vq <br />Bf Minerals <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS <br />APPLICATION FORM <br />DEPARTMENT OF <br />NATURAL <br />RESOURCE <br />Roy Romer <br />Governor <br />lames S. Lochhearl <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 Waranty (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 ( <br />Permit #: $0- '.~ Confidental?: _~_ <br />Class: Type-Seq.: SO - a <br />From:I.~.st Ylellile lJ•.I~anfi-.To: 1e~58 <br />Doc. Name: Stre~ssrad~ e~ (7 <br />Doc. Date (if no date stamp) ~_!- ~ o~- <br />2acelF& "1$ 43 ~ t as . 00 <br />I.Option A: <br />(Initial & Date) <br />2.Option B:~_ <br />(Initial & Date) <br />D <br />~. <br />c'~ <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 FMANCIAL <br />WARRANTY COULD BE SUBSTANTIALLY 1NCREASF9 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 />