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~L,Mr~ ~-r-ut~l(~ I.IAUC~6~fZJ .~ ~~~ <br />,'..: <br />STATE OF COLORADO <br />DIVISION OF MINERALS AND GEOLOGY ~/c <br />Department of Natural Resources RC('~ E'V GD <br />_ 1313 Sherman St., Room 21 i IIGG vv <br />Denver, Colorado 80203 'I p p O t v I S l O N <br />Phone~.(303) 866-3567 M„R u 4 2003 ~ M I N E RA <br />FAX: (3031 832-81 0b &' <br />GEOLO< <br />Division of Minerals and Dea10>ty ry E C L A M A T I <br />' 111NING•SAFE <br />' TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS Bill Owenz <br />APPLICATION FORM Governor <br />Creg E. WalCher <br />Executive Director <br />Michael 8. Long <br />Division Director <br />The application for a Transfer of Pemrit and Succession of Operators must contain four (4) major darts: 1) an Application <br />Form; 2) an Application Fee; 3) a Performance Waaaztty (attached as part of the Application Package) beating the original <br />notarized signature of the Successor Operator; 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 />I. FINANCIAL WARRANTY INFORMATION (Choose ONE Option): <br />1. do <br />(Initial & Date) <br />I wish to WANE MY RIGHT to a 30day processing time to allow <br />tl3e Division of Minerals and Geology to recalculate the Financial <br />Warranty requirements. Ifyou choose Option A you should not submit <br />a Financial Warranty and Performance Warranty until the Division <br />notifies you of the correct amount of your warranty requ'uements.* <br />2. lion B: <br />(Initial & Date) <br />~ECEivE~ <br />MAR 0 41003 <br />Division of Minerals artd Ceob~ <br />I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing <br />time. 1 hereby submit a replacement Financial Warranty for the same <br />dollaz amount as the Financial Warranty maintained by the current <br />operator. I understand that the Division of Minezals and Geology will <br />reca]culatetherequired7eclamationbond within 60-days from the date <br />that the transfer is completed and the required FINANCIAL <br />WARRANTY-COULD BE SUBSTANTIALLY IN REA ED at that <br />time. As the new operator; I agree to be responsible for posting any . <br />required increase to the fmarcial warranty for good cause shown, in a <br />form acceptable to the EDard, within 60-days of such notice. <br />NCN=C~V I~i~IIDB'1 <br />R~=31n1o3 <br />