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Application Checklist <br /> 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 /> l/Financial Warranty: Submit the appropriate Financial Warranties or conditional <br /> replacement Financial Warranties using the forms posted on the Division's website <br /> (a ilable online at http://mining.state.co.us/Mineral%20Fonns.htm). <br /> ✓ L{{Aat/ <br /> Demonstration of Legal Right to Enter: Identify the owners of all surface and mineral <br /> r'z <br /> hts, obtain the documentation described above, and submit to the Division. <br /> ✓ rr��54-As r <br /> Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> to do so. <br /> RECEIVED <br /> AUG 2 8 2017 <br /> 'visiof)of Reclamation, <br /> Mining&Safety <br /> - 4 - <br />