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STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY <br />Department d Natural Resource ~+ 7 i <br />13135herman St., Room 215 ~/~_Ql~ REV E4VE~ coLORADo <br />Denver, l..olorado 80203 V DIVISION O F <br />Phone: D03) 8663567 ~~V -~~ MAR 1 4~ M I N E&RA L S <br />FAX: (303) 832$,06: ~~.- ~'~~/O~ G E O L O G Y <br />•ECUNATtO N•NIN ING <br />ilxittaaafMiaeralsond SArETT•SCIENCE <br />'TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS aitl Owens <br />Gwmsa <br />APPLICATION FORM '~~ RIESaea George <br />ExeMive DireROr <br />I ,,,, ~/1 • ""~~ ~pAg Rolww w. Caaa~+r <br />h 1,• Moms ~ <br />I' /0" I •.l ~`"P ~'~~ ~_ ~ y Division Directs <br />Natural Resource Trustee <br />Tkit jorn, has bey approved by ilsrMaaed Land Reelarxatian Board pars:aaret to secdions 3Q-32-1 d 7, C.R.S, ojike Mfreed Land <br />ReclmnabonAd and 34-32..~I17, C.1ZS, oj~eColoradoLand ReckpFa~onAdjortheExbaelion ojConsbadion M~erials Any <br />alteration or ~ ojtlEis jorm, raitltout approval by tlreBoard shall result kr tkefuro»Eaal,amarrtybe6gw,raSd ondresrtltin <br />the voiding ojany perndt issued in cenjunetion »+it/i suck inva6tlJinmuial,wrranty and subject the operator m cease and desist <br />orders and uw7pena/ties for operding,vithoutapermitpursuontto sections 34.32-I23, GRS, ojthebfaEed Land ReelmnationAd <br />and 34-32.5-123, C.ILS., of Nu Colorado Land ReEdmrEa(ion Ad jar the Favadion of Construction Materials. <br />The application far a Transfer of Permit and Succevsion of Operators must contain four (4) major parts: 1) an Application Form; 2) an <br />Application Fee; 3) a Perfmmance Warranty (attached as part of the Application Package) bearing the original notarized signature of the <br />Successor Operator, sad, 4) a replaExmmt Financial Warranty provided by the Successor Operator, bearing an original notarized sigoattse. <br />To expedite processing, please provide the informatitm in the format and order described below. <br />FINANCIAL R'ARRANTY INFOR)\iATION (Choose ONE GDtiOn): <br />I. ODtbn AA:.-tl~ 8 Me,/'Oro <br />{Initial & Date) <br />2. Option B: <br />(Initial &. Date) <br />I wish to WAIVE MY RIGHT to a 30-day processing time to allow the <br />Division of MitEeral.N and Geology to recalculate the FiDancial Warranty <br />requirements. Ifyou choose Option A you should no submit a Financial Wartmuy <br />and Performance Warrmry Emtil the Division Doti&es you of the correct amount of <br />yo,n• warranty rtXluiraEnems. • - . <br />I DO NOT WISH TO WAIVE MS' RIGHT toe 30~deIE processing time. I <br />hereby submit a replacement Financial Warranty for the same dollar amount as the <br />Financial Waranty maintaiDed by the current operators. I tmderstand that the <br />Division of Minerals and Geology will recalculate the required reclamation bond <br />within 60-days from the date that tbe transfer is completed sect the required <br />F~iANCIAL WARRANTY COULD BE SL T.4N7'tAt t v 1NC FASID at <br />that time. As the new operator, I agree to be responsible for posting a~ required <br />increase to the financial wazrmty for good cause shown, in a form acceptable to tbe <br />Board, within 60-days of such notice. <br />Oaice d Office of Colorado <br />Mined land Reclamation Active and Inactive Mines Geological Survey <br />