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Y-0- i qqq - C017 <br />z`nGt Application Checklist <br />q -)e h,3A &OV -12 - <br />Application Form: Complete the form located on page 5. <br />IkF Application Fee: Include check payable to Ct,lorado Division of Reclamation, Mining <br />and Safety. <br />RPerformance Warranty: Complete the form located on page 11. <br />Fi ancial Warranty: Submit the appropriate Financial Warranties or conditional <br />placement Financial Warranties using the forms posted on the Division's website <br />(available online at http:,.-'..-'mining.state.co.us:"MineralO-62OForms.htm . <br />W (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 />�( r-, 42x— fa a � —AV �%3C/,w I'A"L/C— <br />L[]' rstructure Agreements: Obtain new Structure Agreements if Permittee had been required <br />to do so. <br />!'),11 4C��Ze"j(7( � 4 r��. l jr�C�CS1� <br />6r, 1* <br />-4- <br />