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aDo1 os� <br /> Application Checklist <br /> 50 Application Form: Complete the form located on page 5. <br /> 3/2f/I 0 <br /> E% Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br /> and Safety. 112G .$) y y <br /> Performance Warranty: Complete the form located on page 11. <br /> /u A, ❑ 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 httn://mining.state.co.us/Mineral%20Forms.htm). <br /> Id 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 /> Cal. Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> �j/241XI to do so. <br /> RECEIVED <br /> FEB 09 2016 <br /> Division of Reclamation, <br /> Mining&Safety <br /> - 4 - <br />