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Application Checklist <br /> ® Application Form: Complete the form located on page 5. <br /> m Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br /> and Safety. <br /> I� Performance Warranty: Complete the form located on page 11. <br /> l-e c,d Financial Warranty: Submit the appropriate Financial Warranties or conditional <br /> J 1z v replacement Financial Warranties using the forms posted on the Division's website <br /> (available online at httn:/'mining.state co us/Mineral%20Forms htm). 1 5-6,1 D 3-7 <br /> rrn,(,d CY Demonstration of Legal Right to Enter: Identify the owners of all surface and mineral <br /> Jdttj -71 rights, obtain the documentation described above, and submit to the Division. <br /> Ga Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> to do so. <br /> RECEIVED <br /> JUN 3 0 2016 <br /> Division of Redamabw <br /> Mining&Safe# <br /> -4 - <br />