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04�A <br /> RECLz1vE <br /> D <br /> OCT 10 Z0la <br /> Application Checklist ®IVM�N�NOF <br /> REC UT <br /> 1 � AND SAFEjI.� <br /> f � _Application Form: Complete the form located on page 5. <br /> Itil� <br /> Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br /> a d Safety. <br /> Performance Warranty: Complete the form located on page 11. <br /> Financial 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 littp://mining.state.co.us/Mineral%201'orms.htm). <br /> E7 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 /> Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> to do so. <br /> S001 <br /> M-2017-027 S001 <br /> Complied! No Violations! <br /> 0 Minor Infractions SJM/whe <br /> 3M C, yt,U <br /> -4- <br />