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STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department d Natural Resources <br />13t 3 Shannon st., Room zt s C O L D RA D I <br />DP11Vet l.otorddo 802a3 <br />Phone (303) 8663567 O l V 7 5 r O N O <br />M [ N E RA L <br />FAx: t3o3) s3xato6 G E O L O G <br />TRANSFER OF PERMIT AND SIICCESSION OP OPERATORS am arem <br />Governor <br />APPIdCAT[ON FORM area cear~ <br />Executive oireua <br />Ronald W. Conant <br />Dhtision Direcmr <br />Nazunl Resotxce Tnnree <br />Tlria joint kaa beat approved by rke Mina! band Rcclatttation Bond ptlrstrant to saYions 34-32-777, GR.S, ojike Mined Land <br />~Ad and 34d2.S117, C.RS, ojWe ColomdolandRedatmdatAd jot tkaF,avadion ojCarwtediart MaWiah Any <br />aBoamlon arnwdtJlcooion ojtlalsjorm, ~rot~approaa[bytkeBoordakaQresndtkr 6refmmrriat x+mrrmttybemgktwr6dandresv8ui <br />~ S oj~YP~ fssated in av>~ttrdion »~ stick 6rvaSd financial wvrrmtry and .wbject eke opwator to curse and desist <br />ordosandcivSparadltoforopcro7ns8wblrontapramitpnasamismsedions3¢3Z-123, GNP, ojt6ed!medLmedReclmnationAd <br />and 34-32.5-123, CR&, ojthe Colorodo Land Redmnarioa Ad jot ~eFxJradion rJCons2rrtcSon Materida. <br />The application for a Transfer of Permit ead Stttxxsaiaa ~' Operators must contaia four (4) major parts: t) an App]cation Farm; 2) an <br />Application Fees; 3) a Perfaamance Warranty (attached as part of the Application Package) beating the original notarized signature of the <br />Stmce.4sca OptxatoE; eud, 4) a replecemalt Financial Warranty provided by the Successor Operator, bearing an originet mtarvod signatte. <br />To cttpedite processing, please provide the information in the format and order tiesaibed below. <br />FINANCLA~ R'AR_RANTV IIVFOIi`MAT(ON <br />11/~Z~OJ <br />1. Ootbn A: ~ I to WAIVE MY RIGHT to a 30~ay processing time to allow tt~ <br />(Initial Sc Date) Division of MmcraLc and Geology to recalailate the Firtantasl Warranty <br />regttirt'~is IfyouchooseOptionAyoushotdd ti sulanitaFinmtcialWmranty <br />and Perfotma~e Warranty tmtil the Division notifies you of the correct emotmt of <br />yota warranty re9uiremenis.s <br />2. Qptfwl B: I i20 NOT WISH TO WAIVE MY RIGHT to a 30day proassing time. I <br />(Initial $ Date) hereby submit a repleceriteot Finmcitd Warranty for the same dollar emotmt as the <br />Financial Warranty maintained by due current operator. I tmderstarrd that the <br />Division of Minarets and Geology will recalctilate the required reclamation bond <br />within 60-days from the date that the transCc is cx~tnlaleted and 8x required <br />FINANCLAI W/~uRaRlTy~OUi~I BF SUBS'~INTIAi_i Y INCREASID at <br />that time. As the new operator, I agree to be responsible for poslmg any re9uired <br />incxease to the fniaacisl wattaary fa good cause s~wq in a form acceptable to the <br />Board, witlrin 60-days of such no>ice. <br />Office of Office of Colorado <br />Mined Wrid Ralarnation Alive and Inactive Mines Geological Survey <br />