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M-4/-o3s <br />DIVISION Of MINERALS AND GEOLOGY <br />Depanmcnl of Natural Resources <br />I l I3 Shemwn 51., Rorsm 21 i <br />Denvcv, Colorado 80203 <br />Plsone:13031 866-1567 <br />FAX: (3UN 832-81 q6 <br />TRANSFER OF PERMIT AND <br />STATE OF <br />,e~y,~I`~ ~lo~s/ asap <br />COLORADO <br />RECEIVED <br />JUL 1 5 2002 <br />Division of Minerals and Ceelogy <br />UCCESS[ON OF OPERATORS <br />Roy Romer <br />APPLICATION FORM ~nw <br />antes 5. LocfiheaA <br />Executive Diseaw <br />Michael B. Long <br />Division Dlrectw <br />The application for a Transfer of Pemlit and Srtccession of Operators must contain four (4) major parts: 1) an Application <br />Form; 2) an Application Fee; 3) a Perfotraance Warranty (attachod 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 />Permit #: M-lQ9/ - 03S Confidental?: N <br />Class: /~iryi3i Type-Seq.:SD-3 <br />From: To: Drn6 <br />Doc. Na e: v <br />I. FINANCIAL WARRANTY 1NFORMA7 Doc. Date (if no date stamp): lS Dv2 e t <br />1.Option A: I wish to WAIVE MY RIGHT to a 30-day processing time to allow <br />(Initiai & Date} the Division of Minerals and Geology to recalculate the Financial <br />Warranty requirements. <br />2. ODtlon B: ,~~ I D9~lOT WISH TO WAIVE MY RIGHT to a 30-day processing <br />(Initial & Date) 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 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 pose shown, in a <br />fomr acceptable to the Board, within 60-days of such notice., <br />1vOVf N~ DSO oilttDY1 <br />~~ Il ~ 502 <br />