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Application Checklist <br /> 9�1 <br /> ‘c,09141 Application Form: Complete the form located on page 5. <br /> IYl`� <br /> (Dui/ .T, Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br /> and Safety. (h�,c, ` '(U�f $115 reed, <br /> f al- to-11 'Performance Warranty: Complete the form located on page 11. <br /> 9/1/4- 141Financial Warranty: Submit the appropriate Financial Warranties or conditional <br /> replacement Financial Warranties using the forms posted on the Division's website <br /> (available online at http://mining.state.co.us/Mineral%20Foims.htm). <br /> I c to-Li ❑ Demonstration of Legal Right to Enter: Identify the owners of all surface and mineral <br /> Vivt rights, obtain the documentation described above,and submit to the Division. <br /> ROA /G f1 Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> �/ ( d' to do so. <br /> RECEIVED <br /> 1 -h 6 k/I d,eavi m► <br /> AUG 1 4 2077 <br /> Division of Reclamation, <br /> Mining&Safety <br /> -4 • <br /> - <br /> i <br /> 3 <br />