2014-01-30_REVISION - M1992045

• Permit No: M1992045
• IBM Index Class Name: REVISION
• Doc Date: 1/30/2014
• Doc Name: Incomplete Applicatin for Transfer of Mineral Permit and Succession of Operators
• From: DRMS
• To: Gold Basin Mine, LLC
• Type & Sequence: SO3
• Email Name: BJC
• Media Type: D
• Archive: No

DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
1313 Sherman St., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
January 30, 2014
Mr. Laurens W. Leffingwell, Jr.
Gold Basin Mine, LLC
c/o Simpson Estates, Inc.
30 N. La Salle St., Ste 1232
Chicago, I160602
STATE OF COLORADO
fit. l ' -` 4r-
Re: Gold Basin Mine, Permit M- 1992 -045: Incomplete Application for Transfer of Mineral Permit
and Succession of Operators, Revision SO -03
Dear Mr. Leffingwell:
COLORADO
D I V I S I ON OF
RECLAMATION
MINING
SAFETY
John W. Hickenlooper
Governor
Mike King
Executive Director
Loretta E. Pineda
Director
On January 28, 2014, the Division of Reclamation, Mining and Safety received Annual Fee and Report, Performance Warranty,
Financial Warranty, W -9, Affidavit of Authority, Demonstration of Legal Right to Enter and Structure Agreement- NA
for the Gold Basin Mine, Permit M -1992 -045. The following items are incorrect and enclosed for correction:
1. Performance Warranty notary acknowledgement is incorrect listing the notary's name and not Laurens W. Leffingwell.
2. Financial Warranty Check for Deposit in State Treasury Third Party notary acknowledgement is incorrect listing the notary's
name and not Laurens W. Leffingwell.
3. Affidavit of Authority for Laurens W. Leffingwell notary acknowledgement is incorrect listing the notary's name and not
Laurens W. Leffingwell.
The Annual Report and Fee was provided December 19, 2013 by James Van Ella. Your check is enclosed, returned to you. Gold
Basin Mines, LLC will receive the next annual report and Fee notice due by December 26, 2014.
The Prospective Successor Operator signature page by Laurens W. Leffingwell with the corrected notary acknowledgement, noted
being sent under separate cover, has not been received as yet.
In order to complete the acceptance of this application, please return the original signature documents enclosed for correction to the
State at the above address by February 21, 2014.
The Demonstration of Legal Right to Enter and Structure Agreement documents provided are accepted.
If you have any questions, contact me at (303) 866 -3567 ext 8148.
Sincerely,
—1-6ka1t4<, &kA-"
Barbara Coria
Financial Assurance Specialist
Enclosures
Certified Mail No. 7012 3460 0000 6384 5788, return receipt requested
cc: Dustin Czapla, Division of Reclamation, Mining & Safety
James Van Ella
j on(i�simpsonestates. com
GeorgeRobinson @R2Incorporated.com
Office of Office of
Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines