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<br />-STATE oF COLORADO <br />DIVISION Of MINERALS AND GEOLOGY <br />Dgmvnelrt of teal Resources <br />13 <br />Dower, 13 Sherman St., Room 215 <br />? r)/r <br />Phone (30 0 303 l J ? A ®Z L?- <br />PAX (303) 832.8106 <br />1414 and <br />TRANSFER OF PER&IIT AND SUCCESSION OF OPERATORS <br />APPLICATION FORM <br />COLORADO <br />DIVISION OF <br />MIN RALS <br />GEOLOGY <br />It EC U NAT 10 N•N IN INC <br />WETT•iCIENCE <br />Big Owens <br />cAverwr <br />Executive Director <br />RonaW W. CRWW <br />?0-o ?f`?qq 11 ? [(, , /? / I . Division Director <br />ll?? ` ?4' WW 1?1/? h"? (^C. N&uW ReaaxceTnetee <br />7Ida form boa bear gpromd by O t MW- M Land R orr Board prnnwd to seociNons 34-32-117, CRS, of dke Mixed Land <br />Ju-,fig-ol-ddol -1 Adand 34 32.5-117, CRS, of the Cakwa& Lmrd JteciwxadmAdfor dke Ex&ac iox of Cmtvfp?Alm Any <br />aAw -9 xorboj1kisJbn%*i9hoWgpro+?adbydk*BwwdskoR.esuftin&efboo&ddww?u*baaeg,6tvWWA re3wrar <br />the Wi of mrypoanr * olsmod bt wigh diox *0 =ck ar+affd fao ! ;'rEarmdy and sub, jed *e opens or to come and desist <br />condorssyncd+Bpeara?oFesjorop?erambe?1laiblkoratapea? prwaumaitoaesdloxs3 32-113, CRS,ojdkeMbredLaxdRe 6sAcr <br />std 34.31.5.113, CRS, of elks Co v Lord Rakii"m Adfor the Fad of ComoudFan Mdwwk <br />The application for a Trams of Permit and Succession of Operators must contain farm (4) major parts: 1) an Application Form, 2) an <br />Application Fee, 3) a Performance, Wwran(p (suachod as part of the Application Package) bearing the original notarized signature of the <br />Sneoessor Operator; and, 4) a replecEment Financial warranty provided by the Successor Operator, bearing an aripial m =zed sigaatu m <br />To eopexhW prooessin& Please provide the informatics in the format and order described below. <br />1. EMAA tVG" M ARIAM 89RM_ATION ( = 909M: <br />1. Outhn A: I wish to WAFVE MY RIGHT to a 30-day processing time to allow the <br />(Initial 8e, Date) Division of Minerals and Geology to rec:alc ulate the Financial Warranty <br />requirements` Ifyo u choose Option A you should &S submit a Financial Warranty <br />and Performance Warranty until the Division notifies you of the correct amount of <br />you wWM"y <br />2. : ? Iwlc Y?106 I M NOT WISH W WAIVE MY;2IGH? to a 30-day processing time. I <br />(Initial & Date) hereby stibmit a replaoemew Financial Warranty for the same dollar amount as the <br />Financial Warranty maintained by the current operator. I understand that the <br />Division of Minerals and Geology will recalculate the required reclamation bond <br />within W-days from the date that the transta is completed and the required <br />FKkNCIAT WADY COQ BE StMSTA U3AUy DICR-$A ED at <br />that time. As the new operator, I agree to be responsible for posting any required <br />increase to the finaticial warranty for good cause shown, in a form acceptable to the <br />Board, within 60-days of such notice. <br />office Of office Of Colmado <br />Mined Lard Reckunation Active and Inactive Mines Geological Survey