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STATE OE COLOIZRDO <br />DfVI510N OF MfNERALS AND GEOLOGY <br />L)C{>Jtlmcnl Oi !Nd~urdl RC40ufCE$ <br />I it~tihrrman 9., Room "3 <br />Dein c'. Culnrndp AU'_03 <br />Phunc'. X303' 866-iSf,J <br />FA %.,3U 5i 8;1-fllUb <br />F~F~E~~i ED <br />DEPAP.T~LNT C`f <br />NATURAi <br />RESOURCE <br />sup ~ s zoo2 <br />Division of Minerals and Geology <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS <br />APPLICATION FORM <br />Roy Romer <br />Governor <br />lames S. Lo<hheaA <br />Execwi.~e Director <br />Michael 8. Long <br />Division Direuor <br />The application for a Transfer of Permit 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, bearing an original notarized signature. To expedite processing, please provide the information in the format <br />and order described below. <br />Permit #: Confidental?: dl <br />Class: Type-Seq.: Sn - Z <br />I. FINANCIAL. R'ARRANTY INFORMATION ( From: b(2~t' ~ u T r. To: M <br />Doc. Name:.C9 Ne/n2rn Z-,.t. ~_N /Cr.i~ U.b T+~c. <br />Doc. Date (if no date stamp): "j~~l oa <br />l . 0otion 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. <br />O~ <br />2~ <br />2. Ovtioo B; 3 X27 0?. ~ t DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing <br />(Initial & Date) time. 1 hereby submit a replacement Financial Warranty for the same <br />dollar amount as the Financial Warranty maintained by the current <br />operator. [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 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 Board, within 60-days of such notice. <br />~a~= rn~>ggzo~o ~~ <br />(~~ = ~o~(0~02 <br />