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tA <br /> C�w Application Checklist <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 /> performance Warranty: Complete the form located on page 11. <br /> L9 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 http://mining.state.co.us/Mineral%20Foriiis.htm). <br /> 2- l-A <br /> to u 1rm�,w Dnstration of Legal Right to Enter: Identify the owners of all surface and mineral <br /> *D CdA4,& �841�ig;os, obtain the documentation described above, and submit to the Division. <br /> bl Structure Agreements: Obtain new Structure Agreements if Permittee had been required <br /> to do so. <br /> 4 A <br /> RECEIVED <br /> DEC 1 F 2018 <br /> "II cif f'edamation, <br /> P,11111nu S safety <br /> -4 - <br />