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�4 14 fo -(-)(a <br />C 14'l w ,6 En-s <br />Application Checklist <br />2A3f �e, <br />Q Application Form: Complete the form located on page 5. Pf 17 Ou,� L� �tiN�l✓ <br />Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />ttt, and Safety. $ t Lf O o D <br />IS Performance Warranty: Complete the form located on page 11. <br />12 -laa3 r°e*f <br />0 Financial Warranty: Submit the appropriate Financial Warranties or conditional <br />replacement Financial Warranties using the forms posted on the Division's website <br />(available online at http: / /mining.state.co.us /Mineral %20Forms.htm). $ (,aq, y3Y 0a <br />�"�1G ❑ 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 />❑ Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />to do so. <br />-4- <br />