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#4 lite-21114. <br />ApplicationChecklist <br />Ca Application Form: Complete the form located on page 5. <br />7 Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />Q' Performance Warranty: Complete the form located on page 11. <br />Et 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 />,��' l' 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 />(Gt/,(� t0.211' DLM - G NtG ,-8.4,0.522 taps 4s-fAC4+ 00 <br />❑ Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />to do so. NO STROGIOE_S LEE NO Z ?LACER <br />RECEV_D <br />SEP 14 2015 <br />Division of Reclamation, <br />Mining & Safety <br />-4 <br />