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�U <br /> (� 7-7- SSA <br /> Application Checklist <br /> ER 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 /> ® Performance Warranty: Complete the form located on page 11. <br /> ❑ 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 http://mining.state co us/Mineral%20Forms htm). <br /> ® 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 /> l� Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> to do so. 96447;'1 jif'ot <br /> ✓`�____�- � I ,� /j�: n 1 r' : r i.✓c�1 Y s"J/'G of '✓'',+ d r �f,' ,f <br /> V 1- <br /> RECEIVED <br /> AN 1 ZGi? <br /> f Reclamation, <br /> &Safety <br />