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pokfillkftcti <br />rtifb( <br />Application Checklist <br />Application Form: Complete the form located on page 5. <br />o -o <br />44.E 40-04' l or <br />RJ Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />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, 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 />4 <br />RECEIVED <br />JUL 23 2015 <br />Division of Reclamation, <br />Mining & Safety <br />