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0,h j STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY RECEIVED <br />Department of Natural Resources <br />R <br />1313 Sherman St., Room 215 JUN 17 2010 ? C O L O AD O <br />Denver, Colorado 80203 D I V I S I O N OF <br />Phone: (303) 866-3567 RECLAMATION <br />FAX: (303) 832-8106 Division of Reclamation, MINING <br />Mining & Safety SAFETY <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERAT RS <br />APPLICATION FORM <br />r4'P+ /y La C-, a'j\-J <br />?2•. C?i,, ?a.;, P, VIC . <br />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 />FINANCLAL WARRANTY INFORMATION (Choose ONE Option): <br />1. Option A. I wish to WAIVE MY RIGHT to a 30-day processing time to allow the <br />(Initial & Date) 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: I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing time. I <br />(Initial & Date) hereby submit a replacement Financial Warranty 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 FINANCIAL WARRANTY COULD BE <br />SUBSTANTIALLY INCREASED at that time. 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 />N0 V i '0W <br />All- -7010 <br />Office of Office of <br />Mined Land Reclamation Denver • Grand )unction • Durango Active and Inactive Mines