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• ` ~Y6n'~ ~o7rhpen~6ti4 m/~e~ICL~s L'o~p. / ~ Z <br />STATE OF COLORADO <br />OlVl510N OF MINERALS AND GEOLOGY <br />Department of Natural Resources <br />~( .. <br />~' . `"i. <br />'~'T~o~ Y'y~ ~® <br />Q ~3 ~ <br />~~o <br />BAdrm <br />~,d <br />AND SUCCESSION OF OPERrt'RS <br /> <br />1313 Sherman SL, Room 215 <br />Denver, Colorado 80203 <br />Phone: 1303) 866-3567 <br />FAX: (3031 832-8106 <br />T + • TRANSFER OF PERMIT <br />APPLICATION FORM <br />D I V I S I D N <br />M[NERA <br />&~ <br />GEOLO( <br />R E-ClA MATT <br />f't4NING•SAFE <br />Bill Owens <br />Governor <br />Greg E. Wal<her <br />Execwi~e Director <br />Michael 6. Long <br />Division Director <br />The application for a Transfer of Pemut and Succession of Operators must contain four (4) major parts: 1) an Application <br />Form; 2) an Application Fee; 3) a Performance Warranty (attached as part of the Application Package) bearing the original <br />notarized signature of the Successor Operator; and, 4) a replacement Financial Warranty provided by the Successor <br />Operator, beazing an original notarized signature. To expedite processing, please provide the information in the format <br />and order described below. <br />FINANCI T WARRANTY INFORMATION ( hoose ONE tion): <br />1. Option A: I wish to WAIVE MY RIGHT to a 30-day processing time to allow <br />(Initial & Date) the Division of Minerals and Geology to recalculate the Financial <br />Warranty requirements. If you choose Option A you should ~ submit <br />a Financial Warranty and Performance Warranty until the Division <br />notifies you of the correct amount of your warranty requirements.' <br />2. n B: S oS'a~-~'~ DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing <br />(Initta & Date) time. I hereby submit a replacement Financial Warranty for the same <br />- ', dollaz 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 COiJLD BE SUBSTANTIALLY INCREASED at that <br />time. As the new operator, I agree to be responsible for posting any <br />required increase to the fm;u~ial warranty for good cause shown. in a <br />form acceptable to the Eoard, within 60-days of such notice. <br />N OV = N ONE <br />~%=5}q~o4 <br />