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Ci2rAls <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Shaman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866 -3567 <br />FAX: (303) 832-8106 <br />Division of Reclamation, <br />Mining & Safety <br />The application fora Transfer ofPermit and Succession of Operators must contain four 4 <br />an Application Fee; 3) a Performance Warranty ()major parts: 1) an Application Form; 2) <br />siga signature of the Successor ee3) a y (attached as part of the Application Package) bearing the original notarized <br />ul no f the Operator; and, 4) a replacement Financial Warranty provided by the Successor Operator, bearing an <br />signature. To expedite processing, please provide the information in the format and order described below. <br />Office of <br />Mined lard Reclamation <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS <br />APPLICATION FORM <br />FINANCIAL WARRANTY INFORMATION ( 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 rents.* <br />2. t'on B: <br />I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing time. I <br />nitial & Date) hereby submit a <br />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 <br />COULD BE <br />SUBSTArTTIALLY INCREASE) at that time. As the new <br />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 />Denver • Grand Junction <br />STATE OF COLO1ADO <br />R <br />0E0 052011 <br />D <br />AF 1`.‘-t- 5 k5 a(W <br />Office of <br />Active and Inactive Mines <br />