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UAM ,tel 1 asr; Boz <br />RECEIVED <br />Application Checklist APR 0 2 2015' <br />® Application Form: Complete the form located on page 5. <br />,'isW) of Rectamation, <br />f,,;,, ,; & Safely <br />❑ Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />R Performance Warranty: Complete the form located on page 11. <br />��Q CSI Financial Warranty: Submit the appropriate Financial Warranties or conditional <br />V' ;�l5 replacement Financial Warranties using the forms posted on the Division's website <br />V (available online at http://mining.state.co.us/Mineral%20Forms.htm). <br />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 />Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />to do so. <br />0k- <br />4111(15- <br />1 �(I s i A6 1. &W <br />M <br />