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Application Checklist <br /> ET/Application Form: Complete the form located on page 5. <br /> v 0 Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br /> and Safety. <br /> D Performance Warranty: Complete the form located on page 11. <br /> U 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 hgp:Hmining,state.co.us/Mineral%20Forms.htm). <br /> 0 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 /> ✓ �0 Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> to do so. <br /> DECEIVED <br /> DEC 1 ' 2016 <br /> Division of Reclamation, <br /> Mining&Safety <br /> -4 - <br />