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�- <br /> Application Checklist <br /> ❑ Application Form: Complete the form Jocated on page 5. <br /> ❑� Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br /> and Safety. <br /> 4 <br /> C , ,� ►�J .�? EY Performance Warranty: Complete the form located on page 11. <br /> tN , I1 Financial Warranty: Submit the appropriate Financial Warranties or conditional <br /> p gposted <br /> replacement Financial Warranties using the forms on the Divisions website < <br /> (available online at littp://mining..state.co.us/Mineral%20Fomis.litm), <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 /> ❑ Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> to do so. <br /> 1-3,w4" <br /> RECEIVED <br /> MAY 1 2 r i <br /> 1,;vis!on,of rye( ftamafj-cn, <br /> 1-01,.1unt3&,SafUty <br /> - 4 - <br />