2007-08-03_REVISION - M1982020

• Permit No: M1982020
• IBM Index Class Name: Revision
• Doc Date: 8/3/2007
• Doc Name: Transfer of permit & succession of operators application form
• From: Elmo Nossamen
• To: DRMS
• Type & Sequence: SO1
• Media Type: D
• Archive: No

I ~ 'p
i~ / ~
• STATE OF COLORADO
DIVISION Of MINERALS AND GEOLOGY p~
Department of Natural Resources /'~~~~~~© f~
13t 3 SheFinan Sc, Room 215 RE "~" ` - "~ ~ e ~ ®~~° ~ C O L O RA D O
Denver, Colorado 60203 AU6 0 3 2001 / DIVISION O F
Pholre: (303) 8663567 ,JAS 2 9 2007 MINERAL S
FAX: [phone] pryision of ftec~um ~ 01/ 'ono Ro G E O LO G Y
and Seth'/ Divisl ' clamation,
r0 Mining i RECLANATION•NINING
Ni%ti,tg and Safaiy SAFETY•SOENCE
/1 ~ TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS a+n ovens
~ (/- / / Govemw
v ~ n APPLICATION FORM Ru:seu
~/ (}^ ,, jI// Executive D BreecTOr
' /' „/y'~ N~~~ ~'~~ O ~ `/ ,~ri y /I ~ / Ronald W. Canny
,,,... ///~~~ ff/i rt '_ 1!/YL/W" l/ Division Director
tn~ Natural Resource Trustee
77ns jorm kas been approved by the Mined Lond Reclamation Board pursuant to sections 34-32-117, GRS., ojtlEe Mined Lond
Reclaraaf3onAdand34-32.3-I27,C.RS.,oJtheColoradnlwmdReclamationAdjortheEx4acrianojConstrudion Materials Any
aiferation or modification ojthis jorm, without approval by tke Board shall result in thej'aronwal nnrrarrtybeirrgiaEta6d andresuC4r
tke voiding ojany permit issued in rnnlunExion Evith such invalid furancial xnrranry and subject UEe operator to cease and desire
orders and civrT penalties jor operating without apermitpursuaM to sections 34-32-123, GRS, ofikeMined Land ReclmnationAd
and 34-32.5-123, CRS., ojthe Colorado Land Reclamation Ad jor the Exdaction ojConstrudion Materials.
The application for a Transfer of Permit and Succession of Operators must contain four (4) major parts: I) an Application Form; 2) an
Application Fee; 3) a Performance Warranty (attached as part of the Application Package) bearing the original notarized signature of the
Successor Operator; and, 4) a replacement Financial Warranty providedby the Successor Operator, bearing an original notarized signalise.
To expedite processing, please provide the information in the format and order described below.
FINANCIA L WARRANTY INFORMATION (Choose ONE O ption):

1. Option A: I wish to WAI VE Mir RI GHT to a 30-day processing time to allow the
'list & Date) Division of Minerals and Geology to recalculate the Financial Warranty
~`'/~ 0 7
requirements. Ifyou choose Option A you should not submit a Financial Warranty
end Performance Warlmty until the Division notiSes you of the correct amount of
your warranty requirements.;
f`_J
2. O t~ __^~_
(Initial ~@ Date)
I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing time. I
hereby submit a replacement Financial Warranty for the same dollar amount as the
Financial Warranty maintained by the current operator. I understand that the
Division of Minerals and Geology will recalculate the required reclamation bond
within 60-days from the date that the transfer is completed and the requved
FINANCIAL WARRANTY COULD BE SUBSTANTIALLY INCREASED at
that time. As the new operator, I agree to be responsible for posting any rrquired
increase to the financial warranty for good cause shown, in a forrn acceptable to the
Board, within 60-days of such notice.
Office of C+ffice of Colorado
Mined land Reclamation Active and Inactive Mines Geological Survey