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f-'I-87-l~I <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Deµinmem of Nawral Resources <br />1313 Shemwn St., Roam 215 <br />Denver, Colorado 80203 <br />Phone: 13031866-35G) <br />FAX: 1303)832AI06 <br />TRANSFER OF PERMIT AND <br />OF OPERATORS <br />Roy Romer <br />APPLICATION FORM eoyernor <br />r+mer s. t«hhe,a <br />Ezeculie Dirttrp <br />Michael 8. Long <br />Divrsion Oimctor <br />The application for a Transfer of Pemtit and Suooessien of Operators must contain four (4) major paAS: 1) an Application <br />Fomt; 2) an Appfic>#ion Fee; 3) a Perfom3aztce Waranty (attached as part of ffie Application Package) bearing the original <br />notarized srgnattrne of the Successor Operator; and, 4) a replacement Firnancial Warranty provided by the Successor <br />Operator, bearing an original motarized signature. To expedite processing, please provide the information m the format <br />and order described below. <br />Permit #: M- J4 $7 - t ~r I Confidental?: 'YU <br />Class: Type-Seq~ 519 ~ Z <br />From: rL~ To: J7lVl6 <br />L FINANCIAL WARRANTY INFORMATI( Doc. Nam S A n Ic~M Sou-~~rn~li`b~ <br />Doc. Date (if no ~ stamp): -7j15 Oa <br />1.0etion A: <br />(Initial & Date) <br />2.O~ltion B: G / Q7i <br />(Initial & Date) <br />I wish to WAIVE MY R[GHT to a 30-day processing time to allow <br />the Division of Minerals and Geology to recalculate the Financial <br />Warranty requirements. <br />I DO NOT WISH TO WAIVE MY RIGHT to a 30~ay processing <br />time. I hereby submit a replacement Fitancial Waranty 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 FMANCIAL <br />WARRANTY COULD BE SUBSTANTIALLY INCREASED at that <br />time. As the new operator, I agee to be responsible for posting any <br />required increase to the financial warranty for good cause shown, in a <br />form acceptable to the Board, within 60-days of such notice. <br />RECEIVED <br />JUL 1 5 202 <br />Division of Minerals and Geology <br />NoV= NoN~ <br />