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<br />STATE <br />COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ~ lF~ <br />Department of Natu21 Resources ~~+ <br />1313 Sherman SL, Room 215 w p 1 <br />Denver, Colorado ao203 ~~°~s~oa ryP'r ?6 9~. <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 ~~n"~a/s <br />ap~Ce%g <br />Y <br />TRANSFER OF PERMIT AND SIICCESSION OF OPEBATORS <br />APPLICATION FORM <br />COLORADO <br />DIVISION O F <br />MIN SRALS <br />GEOLOGY <br />0.ECLAMATION•MINING <br />SAFETT•SCIENCE <br />Bill Owens <br />Governor <br />Russell George <br />Executive Director <br />Ronald W.I;.attany <br />Division Director <br />Natural Resource Trustee <br />The application for a Transfer of Pemrit and Succession of Operators mustcontain four (4) majotparts: 1) aD Application Form; 2) ~ <br />Application Fce; 3) aPerfm'mance Warranty (attached aspart ofthe ApplirationPackage) betuingthe originalnotarizedsignanae afthe <br />Successor Operator, 'end, 4) a r'eplacemett Financial Warramy provided by the Successor Operator, bearing an original notarized <br />signature. To expedite processing, please provide the infaama(ion in the format and order described below. <br />I. FINANCIAL WARRANTY INFORMATION (Choose ONE Option): <br />1.0 n A: PC - z, OS <br />(Tmtial & Date) <br />2. potion $: <br />(Initial & Date) <br />I wish to WAIVE MY RIGHT to s 30-day processing time to allow the <br />Division of Minerals and Geology to recalculate the Financial Watranty <br />requirements. If you choose Option A you should not submit a Financial <br />Warranty and Performance Warranty until the Division notifies you of the <br />correct amount of your warranty requiremenfs.~ <br />I DO NOT WISH TO WAIVE MY RIGHT to a 30~ay processing time. I <br />hereby submit a replacementFinancial Warranty for the same dollar amount as <br />the Financial Warranty maintainedby the current operator. itmrlrlctnnrl that the <br />Division of Mnecals and Geology will recalculate the required reclamation <br />bond within 60-days from the date that the transfer is completed and the <br />required FINANCIAL WARRANTY COULD BE SUBSTANTIALLY <br />INCREASED at that time. As the new operator, I agree to be responsible for <br />posting anyregrdredmcrease to the financial wmiaatyfor good cause shown, in <br />a foam acceptable to the Board, within 60-days of such notice. <br />J~lo~ = nJoN~f <br />~!-~ ~ ' o~ I o9lao~s <br />Office of <br />Mined Land Reclamation <br />Office of Colorado <br />Active and Inactive Mines Geoloziral Survev <br />