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i <br />STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sharman St.. Room 215 <br />O L O R A D (J <br />Denver, (:c>iorailo 80203 IRF(CLAMATICIN <br />Phone: (303) 866-.iSFi: 1 v S 1 0 N o r <br />FAX: (303)8:32-8106 ?D? ?? CC MINING', <br />SEP SAFETY <br />i„.: •? <br />Governor <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS Harris D. horrnan <br />APPLICATION FORM Ir--- Exectit ar. Director <br />?M ?? j-jJ ` I ?jI Ronald W. Ca!tany <br />Y/ I <br />K/ Division Director <br />Ndural Resource'rrustr <br />The application for a Transfer of Permit and Succession of Opel ators must contain four 4 major parts: 1) an Application Fee; 3) a Performance Warranty (attached as part of the Application <br /> Package) bearing original notarized <br />signature of the Successor Operator; and, 4) a replacement Financial Warranty provided by the Successor Operator, bearing an <br />original notarized signature. To expedite processing, please provide the information in the format and order described below. <br />1. FINANCIAL WARRANTY INFORMATION (Choose ONE Option): <br />1. Option A: <br />(Initial & Date) <br />I wish to WAIVE MY RIGHT to a 30-day processing time to allow the <br />Division of Reclamation, Mining and Safety to recalculate the Financial <br />Warranty requirements. If you choose Option A you should not submit a <br />Financial Warranty and Performance Warranty until the Division notifies you <br />of the correct amount of your warranty requirements.* <br />2. Option B: <br />(Initial & Date) <br />Office of <br />Minced Land R(xlamation <br />1. DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing time. I <br />hereby submit a replacement Financial YJarranty° for the same dollar amount <br />as the Financial Warranty maintained by the current operator. I understand <br />that the Division of Reclamation, Mining and Safety- will recalculate the <br />required reclamation bond within 60-days from the date that the transfer is <br />completed and the required Y--C,C;tCiLD--BE <br />SUM_ AIN I'C _1,I.LY: N' KL_ASEI? at that tirne. As the new operator, I agree <br />to be responsible for posting any required increase to the financial warranty <br />for good cause shown, in a form acceptable to the Board, within 60-days of <br />such notice. <br />Deriver • C;rand Junction • Durango <br />Office. of <br />Actve and Inactive Mines <br />