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flq 7_ O4 <br /> Application Checklist <br /> Yitei 0 Application Form: Complete the form located on page 5. <br /> 0 Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br /> and Safety. <br /> T4t( * 0 Performance Warranty: Complete the form located on page 11. <br /> ❑ Financial Warranty: Submit the appropriate Financial Warranties or conditional <br /> .�L replacement Financial Warranties using the forms <br /> (available online at htt•://mininc.state.co us\lineral°o2Uforms..htI)osted on the Division's website <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 /> yv6G ❑ Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> to do so. <br /> RECEIVED <br /> act_ 2 5 2017 <br /> ` Ri)ciamation, <br /> Safety <br /> - 4 - <br />