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(VI1ggt1-117 <br />ADDlication Checklist <br />'-� ❑ Application Form: Complete the form located on page 5. <br />re 7 iz� �K'j�G <br />® Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />0 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 />3 p�jCj Imo, ❑ 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 />Ib%r0 ❑ Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />1 <br />to do so. <br />-4- <br />