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0,).-095-05--2, <br />Application Checklist <br />12r' Application Form: Complete the form located on page 5. <br />12' Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />W Performance 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%20Forms htm). <br />Demonstration of Legal Right to Enter: Identify the owners of all surface and mineral <br />rights <br />obtain the documentation descri above, and submit to <br />to DV lalntr — <br />❑ Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />to do so. <br />-4- <br />RECEIVED <br />AUG 18 2W <br />Division of Reclamation, <br />Mining & Safety <br />