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D(Ae, M Iqq2zcl1 <br />Application Checklist <br />❑ Application Form: Complete the form located on page 5. <br />B Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />❑ Performance Warranty: Complete the form located on page 11. <br />"ktffq ZNL, ❑ Financial Warranty: Submit the appropriate Financial Warranties or conditional <br />replacement Financial Warranties using the forms posted on the Division's website <br />FW ret vavc 4j (available online at http: / /mining. state .co.us /Mineral %20Forms.htm). <br />TA}C ❑ Demonstration of Legal Right to Enter: Identify the owners of all surface and mineral <br />rights, obtain the documentation described above, and submit to the Division. <br />SNG ❑ Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />to do so. <br />-4- <br />2tIl3 <br />)`' l 3 <br />-4- <br />