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t,3vA) 0C'�-3 <br /> —/ Application Checklist <br /> B Application Form: Complete the form located on page 5. <br /> CO/Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br /> I and Safety. <br /> API4��Performance Warranty: Complete the form located on page 11. <br /> 1.06..e C(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 htlp:Hmining.state.co.us/Mineral°/`20Forms.htm). <br /> C5 Demonstration of Legal Right to Enter: Identify the owners of all surface and mineral <br /> l� 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 /> ��✓/ .S`2�� �'��C� ��`'�r�.c.��(i ,��t� �-.J ter/ <br /> RECEIVED <br /> 'JUL 01201 <br /> tp►��s�a�Ff�1 �i;, <br /> t471mitt�$ � <br /> - 4 - <br />