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P/1 I&,qq C)gz <br />Application Checklist <br />5t Application Form: Complete the form located on page 5. <br />fel Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />Rl Performance Warranty: Complete the form located on page 11. <br />Q 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://mininiz.state.co.us/Mineral%20Forms.htm). <br />❑ Demonstration of Legal Right to Enter: Identify the owners of all surface and mineral <br />��i1Z.15 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 />Z 010 <br />ale <br />RECEIVED <br />MAY 2 6 2015 <br />Division of Reclamation, <br />Mining & Safety <br />