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m~31 ~ `~ ~ <br />- _ <br />~. ,~Or``: C eao~ F 6rLDe5as <br />~o. a~G <br />TRANSFER OF PERMIT AND SUCCESSION OF OPERATORS <br />i <br />DIVISION OF MINERALS AND GEOLOGY _ <br />Department or Natural Resources _ <br />73t35herman 56, Room 275 =`- - <br />Denver, Cobrado 80203 <br />Phone: 13031866-3567 APIA 2 J 1C05 <br />fAX: f303) 832-8706 <br />llivisian oI Minerals & Gea{ayy <br />APPLICATION FORM <br /> <br />DIVISION O <br />MIIJERAL <br />&- <br />GEOLOG <br />AE-CLAMATIC <br />MINING•SA FET <br />gill Owens <br />Governor <br />Greg E. Walther <br />Execuriye Director <br />Michael g. Long <br />Division Oitectar <br />The application for a Transfer of Permit and Succession of Operators must contain four (4) major parts: I) 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 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 fomtat <br />and order described below. <br />I. FINANCIAL WARRANTY INFORMATION (Choose ONE Ootion): <br />I. ~gtion A: <br />N~ ~ _ <br />r~ I~ --- <br />(Initial & Date) <br />x 2. Qption B ~ t)S <br />(Initial & Date) <br />No~vz~ <br />.~-v <br />~.. <br />STATE OF COLORAL70 <br />I wish to WAIVE MY RIGHT to a 30-day processing time to allow <br />the Division of Minerals and Geology to recalculate the Financial <br />Warranty requirements. ffyou choose Option A you should R~ submit <br />a Financial Warranty and Performance Warranty until the Division <br />notifies you of the correct amount of your warranty requirements.' <br />I DO NOT WISH TO WAIVE MY RIGHT to a 30-day processing <br />time. I 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 Minerals and Geology will . <br />recalculate the requrred reclamation bond within 60-days from the date <br />that the transfer is completed and the required FINANCIAL <br />WARRANTY COULD BE ctrBCTANTIALtY INCREASED at that <br />time. As the new operator, I agree to be responsible for posting any <br />required increase to the financial warranty for good cause shown. in a <br />form acceptable to the Eoazd, within 60-days of such notice. <br />v ~'~,~ S~„7ot7s <br />