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It �7-2/ ? <br />Application Checklist <br />r ` Application Form: Complete the form located on page 5. <br />.viG Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />1224 and Safety. 6'/L k /(f <br />dPerformance Warranty: Complete the form located on page 11. <br />E3' 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 />A-U4d4//A-t 444/MV <br />0 Demonstration of egal Right to Enter: Identify the owners of all surface and mineral <br />rights, obtain the documentation described above, and submit to the Division. <br />,i4ji - <br />Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />to do so. <br />4 <br />RECEIVED <br />JAN 2T <br />EPttdsian�cjf'F���amaliori <br />Nlining&'Safety <br />