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pq S <br /> RECEIVED <br /> Application Checklist JUN 0 4 2014 <br /> Q Application Form: Complete the form located on page 5. Divisim, off �'t , <br /> Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br /> and Safety. <br /> �1 Performance Warranty: Complete the form located on page 11. <br /> ❑ Financial Warranty: Submit the appropriate Financial Warranties or conditional <br /> �B2 ,riZ replacement Financial Warranties using the forms posted on the Division's website <br /> (available online at http://mining.state.co.us/Mineral%20Forms.htm). <br /> ❑ 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. �r� <br /> ❑ Structure Agreements: Obtain new Structure Agreements if Permittee had beers required <br /> to do so. P r KA,► 4— <br /> Pt,IAI at 54-t�- v�n-f✓u'r'c� <br /> -4 - <br />