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(e£i <br /> \.4 '. � l✓ ,r Application Checklist <br /> yv <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 /> (11 <br /> ,fPerformance Warranty: Complete the form located on page 11. <br /> il <br /> / _ 0 Financial Warranty: Submit the appropriate Financial Warranties or conditional <br /> 019-1- (' 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 /> ,,2� //) ❑ 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 /> 11/4V / 0 Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> to do so. <br /> ✓p,t, iivC�) <br /> eiwzmia <br /> 1--td <br /> 1141 r'f/6 <br /> /111 <br /> -4 - <br />