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Application Checklist <br />1 Application Form: Complete the form located on page 5. <br />m 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 />i� i� Financial Warranty: Submit the appropriate Financial Warranties or conditional <br />�4711 � ' \ replacement Financial Warranties using the forms posted on the Division's website <br />\i V (available online at http: / /mining.state.co.us /Mineral %20Fonns.htm). <br />�U 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 />RECEIVED <br />APR 10 Z015 <br />pith -it <br />MLA <br />