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~,M- / y79- / 9',~~ <br />STATE CJF__CQLOIZAD~ <br />DIVISION OF RECLMiAT10N, MtNtNG ANO SAFETY <br />Ocpartment of Naiwal R4~sourc:Cs <br />1313 Sherman St., Room 215 ~~' <br />~ _.^ C O L O R A D O <br />DtVts tOK OF <br />Dem~er, Colorado 00203 ~ <br />303186G-3SG7 <br />~, <br />1 RECLAMATION <br />M1N1NG <br />MAR ~ ~ <br />wnr.:1 <br />P <br />I_ y <br />~ n~ <br />yJm k <br />~ " _ 2008 <br />032-0106 <br />~ ~ <br />~ <br />~ <br />`~ <br />FA>\: (303) <br />I l.((/I vv <br />SAFETY <br />®ivigion of Reclamation - - <br />, <br />~ : iUlining and Safety ~~ affil C>,wenc <br />~(~ <br />1T AND SUCCESSION OF OPERATORS Ga~~emnr <br />L~~ TRANSFER OF PERt~i <br />O Ru~se:lt cenrgc <br />// APPLICATION FORM <br />~~ Execmiw• Direttnr <br /> Ronald W. CattanY <br /> plvisian Direchtr <br /> 1letursl Resovrcs Ttustce <br />The application for a Transfer of Permit and Succession of Opetalors must contain four (4) major parts: i) an Application Corm; 2) <br />an Application Teo; 3) a Pedotmance Warranty (attached as part of the Appiication Package) bearing the original notarized <br />sigttattrre of the Successor Operator, and, d) a replacement Tinancial Warranty provided by the Successor Operator, bearing an <br />original notarized signature. To expedite processing, please provide the information in the format and order desrn~t:d below. <br />I. FINANCIAL WARRANTY iNFOR1~iATTON (Choose ONE Oedatt): <br />I.O to Ion A: I wish to WAtVG MY RIGHT to a 3U-day processing tirtre to allow the <br />(!social & Date) Division of iieclatnation, Ulining and Safety to recalculate the Financial <br />Warranty requirements. If you choose Option A you should not submit a <br />Finaacirtl'Warcattry and P~ fortnam:t: Warrsttty until the Division notifies yrnt <br />of dte concct amouru of your nratTanty requiremcnts.s <br />~ i DO NOT WISH 7'O WAIF UIY ItIGIi'I' to a 3t1-day prncessittg time I <br />2. tion B• ~_. <br />(Initial & Date) hereby submit a replacernctrt Financial Warranty for the same dollar amount <br />as the Financial Warranty ratint;tined by Utc cw'rcnt operator. 1 understand <br />that Ute Division M Reclamation, Mining and Satety wilt recstlculatc the <br />required reclamation band within b0-days from the dale that tlu: Eransfer is <br />cotrq~lcted and the required Fll~r~ "`'`"' wwRRANTY COULD _~ <br />SllI3STA N'17ALLY INCRE S_G at that tituc. As the uca+ operator, l a~co <br />to be responsible far posting any rcyuired increase to the firmrtcial ~van~rtty <br />for goad cause shown, in a farm acceptable to the Board, within GQ-days of <br />such notice. <br />V ~Q~ <br />d - 0 ~ 1" <br />nJ / ~ n <br />~~ ~ ~ ~ o ~~ ~ Jti~d ~ <br />