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STATE OF COLORADO. <br />[X%W0N OF MINERALS ANO GEOLOGY <br />Delurltrnent of RECEIVED <br />1313 Sherman St., Room 215 COLORADO <br />DIVISION O F <br />Derver, Cdarado 803 RS <br />Phom (303) "6.3567 APR 21206 M I N �A L Y FAX (303) 832 -8106 G E O L O G <br />RECLAMATION-MINING <br />NCE Division of Minerals and Geology fAfETT•rCII <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS sill oVIOWS <br />-- . - - - - Governor <br />APPIJCATION FORM Russell George <br />Exatutive arsaw <br />Ronald W. Canary <br />DMsion Dircaor <br />Natural Resource Tnotee <br />77kis form kas boat ayrp vmd by tit Mined Land Redmtadiox Board prrssuant to smoons 34.32 -117, CAS, of tie MbW Land <br />RodwnafimAdartd3" 2.3 - 117, CRS, aftieCok" do LaudRedamadowAdfor the Ex barAmgfCoa. t Mato" Any <br />ake admor»eodricad nofthajor^ widkowtarppronalbyrdkeBoardskarfrem& Intlrelinatdad >a+mrrarttybeatabnwldw irewkin <br />die a 1AW of wypermk ksmed in awomcdim ,nick suck bm4d fimandal woraEty mid subjetat die apoWar to cease and desist <br />orders arced dv9pmaWaJor opw%*xa witkowt apam&pursumrt to sedlsoxs 34-32 -123, GAS, of dre M&ed Lined Rvc&wnadoxAd <br />and 3¢32.5 -123, CRS, of dke Colorado Lard Redema0m Act for the Extradiex of Cows&va% w Mato kh. <br />The application for a Transfer of Permit and Succession of Operators must contain four (4) major parts. 1) an Application Form; 2) an <br />Application Fee; 3) a Performance Wa manty (attached as part of the AppIkAtion Package) bearing the original nouit ized signature of the <br />Successor Opa-ator; and, 4) a replacement Financial Warranty provided by the Successor Operator. bearing an original notarized signature. <br />To expedite processin& please provide the information in the format and order described below. <br />1.Ontim A: ill I wish to WAWE MY RIGHT to a 30-day processing time to allow the <br />& Date) Division of Mmcrals and Gooloa to recalculate the Financial Warranty <br />requiremerim Ifyou choose Option A you shotild ad submit a Financial WarrarAy <br />and Performance Warranty until the Division notifies you of the correct amount of <br />yornr warranty requirements.0 <br />2..$: <br />(Initial dt Date) <br />I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing time. I <br />hereby submit a replacement Financial Warranty for the same dollar ammint as the <br />Financial Warranty maintained by the current operator. I understand that the <br />Division of Minerals and Geok qU will recalculate the required reclamation bond <br />within b0 -days from the date that the transfer is completed and the required <br />FINANCIAL WARRANTY COULD BE SUBSTANTIALLY INCREASED at <br />that time. As the new operator, I agree to be responsible for posting any required <br />increase to the financial warranty for good cause shown. in a form acceptable to the <br />Board, within 60 -days of such notice . <br />Office or <br />O(({or of Colorado <br />Mined Land Reclamation Active and Inactive Mines Geological Survey <br />