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DIVISION OF RECLAMATION, MINING AND SAFETY
<br />Department of Natural Resources
<br />1313 Sherman St., Room 215
<br />Denver, Colorado 80203
<br />Phone: (303) 866-3567
<br />FAX, (303) 832 -8106
<br />March 1, 2013
<br />I'm." Vezzanl
<br />Walserlburg Sank (iravel C'o., h1c.
<br />P.O. Draw'cr 3�2
<br />Walsenburt,, CO 81059
<br />t)TATE OF COLORADO
<br />RECEIVED
<br />JAN 15 2014
<br />Division of Reclamation,
<br />Mining & Safety
<br />Sand Arroyo, Permit i1I- 1978 -283, Annual Fee Invoice and Report Request
<br />COLORADO
<br />D IV IS I ON OF
<br />RECLAMATION
<br />MINING
<br />SAFETY
<br />John W Hickenlooper
<br />Governor
<br />Mike King
<br />Executive Directoi
<br />Lore ttl E Pineda
<br />Director
<br />Pl,EASE READ CAREFULLY — ACTION REQUIItI';D
<br />Please attach Four COIINIPLETED written Annual Report and Annual Re port MaD to this form
<br />Under the terns. Of \'011f- NOI or Reclamation Permit and Colorado Statutes, you must submit Annual Fees and
<br />Annual Reports (including a neap). You must pay the Annual Fee and submit an Annual Report each year until
<br />reclamation re,pon,Ihlht\ release is granted. The .Annual Fee is not a renewal fee. The Fee and Report are for
<br />LAST YEAR'S mining and rcclanlation season, and MUST be paid e\ en if your operation Was inactive
<br />The Annual Report and Fee requirement will be considered submitted N% hell %%e have received the follon'ing
<br />components:
<br />1. APPROPRIATE ANNUAL FEE
<br />2. COMPLETED ANNUAL REPORT
<br />3. ASSOCIATED SLAP as required by rule
<br />If }'ou ha\ e reque,ted reclamation responsibility release front the DI\ lion of Reclamation. i\'Ilning and Safety
<br />("Division-) brit \our perlmt IS not released bi the anm%cr,ar\ date li,ted below, the Ann1Ia1 Fee i\tUST lie palls If
<br />the permit 1, rele.l,ed bcf'01 the anniversary date. th,'il h\ �[.ill1[e. I[ (, n„t IleceSSar- [�, pa\ all : \Illlnal Fee (l I- Slihllllt
<br />an .Annual Iheport f,,r th,u \,•,u -
<br />f)"Ision record, nldic.ltc the ti,u 1 00 ice is due f)r the fall,,\\ 111,
<br />Permit -283
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