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oSZ-- <br />STATE OF COLORADO <br />MINING AND SAFETY <br />" <br />?N OF NRECLAMATION, Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866-3567 <br />FAX: (303) 832-8106 <br /> <br />COLORADO <br />D I V I S I ON Of <br />RECLAMATION <br />MINING <br />SAFETY <br />Bill Ritter, Jr. <br />Governor <br />Hams D. Sherman <br />Executive Director <br />_ n . C1 / „, ,11AJ ? fW)V-r/ (3, 6N- t Ronald W. Cattany <br />llJ? VV?' J Division Director <br />Natural Resource Trustee <br />a -N1 rnU I?V? ?y $0a_4 o k W We? CoMMJ)S) The application for a Transfer of Permit and Succession of Operators must contain four (4) major parts: 1) an Application Form; 2) <br />an Application Fee; 3) a Performance Warranty (attached as part of the Application Package) bearing the 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 />F- CF,- <br />MAY 12 2009 `J <br />Division Of Rec mafioa- <br />Mimin9 and SafetY `? <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATO&S-' <br />APPLICATION FORM <br />I. 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/ -11 <br />(Initial & Date) <br />I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing time. <br />rs <br />• , _ ,. t int rh_ <br />., h nit n'thin F() .I?.., f.,.., r e a?fo_+h?r_rh?rr.?r <br />, <br />to be <br />e- I-Q-6(dAa"°° sh ^ the Board- wi <br />a <br />Office of Office of <br />Mined Land Reclamation Denver • Grand )unction • Durango Active and Inactive Mines