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Wk2t,16p,m <br />ao�3- 0a7 <br />Application Checklist JAN 21 2015 <br />® Application Form: Complete the form located on page 5. --1 Ndamatlon, <br />Mining & Safety <br />Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />a Performance Warranty: Complete the form located on page 11. <br />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). <br />RAE 1 Z3(IS 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 />WW <br />q*J6 d Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />. to do so. <br />-4- <br />