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M- iariy -oo <br />15ti5 STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866 -3567 <br />FAX: (303) 832 -8106 <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS <br />APPLICATION FORM <br />COLORADO <br />D I V I S I O N O F <br />RECLAMATION <br />MINING <br />— &— <br />SAFETY <br />4 <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 />FINANCIAL 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: y/ f I DO NOT WISH TO WAIVE MY RIGHT to a 30 -day processing time. 4 - <br />(Initial & Da <br />Ala -Fey "ri,G1t.4e I <br />awn. K.� we 4 a..•. Diu, oT 1 <br />12 c. <br />f'Y1 isit -Jti <br />i- 30 3-I? -3st. 7 <br />• <br />. • . 14 .. • <br />_- :t•- zt -- - ...,. <br />I <br />fnr grind ranee chnwn, in a form acceptabletn the Rnard s,;thin hn-Aays o <br />smek-notiee. <br />Office of Office of <br />Mined Land Reclamation Denver • Grand junction • Durango Active and Inactive Mines <br />