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M-aoo�'o�1-7 <br />Application Checklist <br />d Application Form: Complete the form located on page 5. <br />t'IcS dui fli1lM1 <br />❑ Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />WPerformance 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%20Fonns.htm). <br />�'��� ❑ 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 />,7 --Lt Cc-mp(,e,& <br />MAY 19 <br />UNision of1m ani cairn <br />IlJali�ir�� � qty <br />RECEIVED <br />GJUL� 00 2015 <br />Division of Reclamation, <br />Mining & Safety <br />-4- <br />