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M igP-t ' <br /> Application Checklist <br /> to-11 !M�' Pi b,/, c1,cD <br /> �" V pplication Form: Complete the form located on page 5. <br /> sit#5.1n / Application Fee: Include check payable to Colorado Division of Reclamation, Mining <br /> �/ and Safety. ( t 2c <br /> 40.4ivi,i n Orrab41 10-1( c tf4 1(04 <br /> 40.4ivi, Perfor ance Warranty: Complete the form located on page 11. <br /> �y�� �\. pi oUb 10•i. 12 4 <br /> 4°1" 1)-12 I Fina, Warranty: Submit the appropriate Financial Warranties or conditional <br /> replacement Financial Warranties using the forms posted on the Division's website <br /> i 0- 12-13, :44 <br /> Z-1 :4' .(available online at http://mining.state.co.us/Mineral%20Forms.htm). <br /> WA <br /> 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 /> t 4 irr <br /> (r ,'L4 • Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> to do so. <br /> RECEIVED <br /> AUG23 gni" <br /> Division of Reclamation, <br /> Mining&Safety <br /> -4 - <br />