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STATE O , OLOI~D <br />DIVISION OF MINERALS AND GEOLOGY <br />Department or Natural ReSOUrceS <br />~U <br />~~ <br />~ f <br />(~ ~~(~~~~ <br />1 11 3 Sherman St., Ronm ?15 ~ ,~.~ I /4I[y6gp 1.(„C~Diyisi /, <br />D <br />l <br />8 <br />1 <br />~ <br />` <br />'~ <br />'Z <br />V <br />t <br />~ <br />'"^ <br />_ ~- ~A 7j>-,_ <br />~(/(/ <br />enver, Co <br />orado <br />0203 <br />Y <br />J <br />/ <br />~ <br />~ <br />_ <br />, <br />~ <br />~. ~ j~~ <br />.'_" - <br />' <br />~` <br />b7 ~ C <br />n <br />o <br />1 <br />~ OA <br />Mr~~a/g z - <br />- <br />~. <br />iAX <br />l3n3 <br />32 <br />81f16 <br />8 <br />-- <br />1 epy <br />~i~ <br /> gy NAT <br />RA <br />,~-c- U <br />L <br /> RESOURCE <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS <br /> Roy Romer <br />APPLICATION FORM Governor <br /> lames 5. Luchhead <br /> Executive Director <br /> Michael B. Cong <br /> Division Director <br />The application for a Transfer of Permit and Succession of Operators must contain four (4) ajor parts: 1) an Application <br />Form; 2) an Application Fee; 3) a Performance Warranty (attached as part of the Applica 'on Package) bearing the original <br />notarized signature of the Successor Operator; and, 4) a replacement Financial anty provided by the Successor <br />Operator, bearing an original notarized signature. To expedite processing, please rovide the information in the format <br />and order described below. <br />I. FINANCIAL WARRANTY INFORMATION <br />1.OQtion A: <br />(Initial & Date) <br /> <br />(Initial & <br />I wish to r~}r /AIVE MY RIGHT to a 30-day processing time to allow <br />the Diyfsion of Minerals and Geology to recalculate the Financial <br />War~anty requirements. <br />(/G 2-- <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 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 Boazd, within 60-days of such notice. <br />NoV~ MVzood~o~ -~Q, <br />~ = I1I16~oZ <br />