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IA 14'0u 07' <br />Application Checklist <br />VI Application Form: Complete the form located on page 5. <br />q4 Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />171 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 />60 Q <br />( d 0 Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />U ` to do so. <br />RECEIVED <br />DEC 04 2015 <br />Division of Reclamation, <br />Aamg & Safety <br />4 <br />