2007-11-14_REVISION - M2005050

• Permit No: M2005050
• IBM Index Class Name: REVISION
• Doc Date: 11/14/2007
• Doc Name: SO application form
• From: Bluerock Energy Corp.
• To: DRMS
• Type & Sequence: SO1
• Email Name: GRM
• Media Type: D
• Archive: No

i i
STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
1313 Sherman St., Room 275
Denver, Colorado 80203 rte Di?
Phone: [phone]
FAX: [phone]
'- OO
R
NOV 14 2007 -
Division of Declamation,
Mining and Safety ?
COLORADO
D IV 15 1 ON OF
RECLA.MATI ON
MINING
SAFETY
Bill Owens
TRANSFER OF P:ER114IT AND SUCCESSION OF OPERATORS Governor
Russell George
APPLICATION FORM EXeCltlive Director
Ronald W. C3ttanv_
Division Director
?? ????? ?/?? ?• ? ? /?O ? ?,?CO ? Natural Resource Trustee
The application for a Transfer of Permit and Succession of Operators must contain four (4) major parts: 1) an Application Form; 2)
an Application Fee; 3) a Performance Warranty (attached as part of the Application Package) bearing the original notarized
signature of the Successor Operator; and, 4) a replacement Financial Warranty provided by the Successor Operator, bearing an
original notarized signature. To expedite processing, please provide the information in the format and order described below,
1. FINANCIAL WARRANTY INFORMATION (Choose ONE Option): `t I "
IJ ?A_j
1. Option A: I wish to )VA1V E MY RIGHT to a 30-day processing time to allow the
(Initial & Date) Division of .Reclamation, Mining and Safety to recalculate the :Financial
Warranty requirements. If you choose Option A you should not submit a
Financial Warranty and Performance Warranty until, the Division notifies you
of the correct amount of your warranty requirements.*
2. Option B: 9/ 5/ 2007 I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing time. I
(Initial & Date) hereby submit a replacement Financial Warranty for the same dollar amount
as the financial Warranty maintained by the current operator. I. understand
that the Division of Reclamation, Mining and Safety will recalculate the
required reclamation. bond within 60-days from the date that the transfer is
completed and the required F NAT`ICIAL WARR`ITY COUI._D I L,.
SUBS'fAa"I=11AI,I^Y IIvCRIsAUT at that time. As the new operator, I agree
to be responsible for posting any required increase to the financial warranty
for good cause shown, in a form acceptable to the Board, within 60-days of
such notice.
A-i?19?- yl?yl?oo?s
X01/ _ j\/ GW
ok -Ro
Office of
Office of
Mined Land Reclamation, Active and Inactive Mines