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M1aeg-tzl <br />Application Checklist <br />B Application Form: Complete the form located on page 5. <br />Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br />and Safety. <br />B Performance Warranty: Complete the form located on page 11. <br />y r/ B Financial Warranty: Submit the appropriate Financial Warranties or conditional <br />�t/ replacement Financial Warranties using the forms posted on the Division's website <br />{available online at hqR://mining.state.co.us/Mineral`/`20Fonns.htm}. <br />B 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 />Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br />l'1 to do so. <br />a RECEIVED <br />NOV 14 2016 <br />Oivision of Reclamation, <br />Mining & Safety <br />-4- <br />