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Application Checklist <br />[T Application Form: Complete the form located on page 5. <br />0 -'Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />D'T�erformance Warranty: Complete the form located on page 11. <br />014inancial 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 hqp://mining.state.co.us/Mineral%20Forms.htm). <br />L -Demonstration of Legal Right to Enter: Identify the owners of all surface and mineral <br />J rights, obtain the documentation described above, and submit to the Division. <br />v y5 -t war 6m4j deed 4P k ass e4Ae6e s Yew 4vt R r -s y� �c <br />B'Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />to do so. <br />RECEIVED <br />JUN 12 2015 <br />Division of Reclamation, <br />Mining & Safety <br />-4- <br />