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-~ <br />1 ~ <br />.~ <br />M-~~-a~~ <br />STATE <br />I~DO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department Oi NaWral Resources <br />13 13 Sherman 51., Room ? l i <br />Denver, Colorado 80'?03 <br />Phone: 1303) 856-J567 <br />fAX: 11031 892-H 106 <br />JUL 26,,200'1 <br />Division of Minerab end GeoloOY <br />/~ ,~i;~ <br />o;,.;S;~~o~ H 1 ~ ~? <br />M;ne~d <br />~~n~CB~~aAY <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS <br />APPLICATION FORM <br />DEPARTMENT OF <br />NATU T <br />RESOURCE <br />RoY Romer <br />Governor <br />lames 5. Lochhead <br />Executive Director <br />Michael 6. Long <br />Division Director <br />The application for a Transfer of Permit and Succession of Operators must contain four (4) major parts: 1) an Application <br />Form; 2) an Application Fee; 3) a Performance Warranty (attached as part of the Application Package) bearing the original <br />notarized signature of the Successor Opemtor; and, 4) a replacement Financial Warranty provided by the Successor <br />Operator, bearing an original notarized signature. To expedite processing, please provide the information in the format <br />and order described below. <br />Permit #: _- ~ Confidental?: ~ <br />Class: t ~ ~ ' Type-Seq.: <br />From: / ~p i e,~`. To: ~n't~ <br />I. FINANCIAI. WARRANTY INFORMATION i Doc. Name: m <br />Doc. Date (if nod a stamp): 7 o'tfo O& <br />1. Oetion A: I wish to WAIVE MY RIGHT to a 30-day processing time to a11ow <br />(Initial & Date) the Division of Minerals and Geology to recalculate the Financial <br />Warranty requirements. <br />~~ , /,~ z <br />2.O~rtion B: -~~L''// _- `7 . I DO NOT WISH TO WAVE MY RIGHT to a 30-day processing <br />(Initial & Date) time. I hereby submit a replacement Financial Waranty for [he same <br />dollaz amount as the Financial Warranty maintained by the current <br />operator. I understand that the Division of Minerals and Geology will <br />tecalculate the required reclamation bond within 60-days from the date <br />that the transfer is completed and the required FINANCIAL <br />WARRANTY COULD BE SUBSTANTIALLY INCREASED at that <br />time. As the new operator, I agree to be responsible for posting any <br />required increase to the financial waranty for good cause shown, in a <br />form acceptable [o the Boazd, within 60-days of such notice. <br />NoY=MV2ooo~0~ ~ <br />~ = I1116~02 <br />