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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 />February 3, 2014 <br />Vincent Sadowski <br />Quikrete Materials, LLC <br />.3490 Piedment Rd., Suite 1300 <br />Atlanta, GA 30305 <br />STATE OF COLORADO <br />RECEIVED <br />MAR 18 2014 <br />Division of Reclamation, <br />Mining & Safety <br />' k <br />Lily Mines, Permit M- 1987 -028, Annual Fee Invoice and Report Request <br />COLORADO <br />DIVISION OF <br />RECLAMATION <br />MINING <br />SAFETY <br />John W. Hickenlooper <br />Governor <br />Mike King <br />Executive Director <br />Loretta E. Pineda <br />Director <br />PLEASE READ CAREFULLY — ACTION REQUIRED <br />Please attach -your COMPLETED written Annual Report and Annual Report Map to this form <br />Under the terms of your NOI or Reclamation Permit and Colorado Statutes, you must submit Annual Fees and <br />Annual Reports (including a map). You must pay the Annual Fee and submit an Annual Report each year until <br />reclamation responsibility release is granted. The Annual Fee is not a renewal fee. The Fee and Report are -for <br />LAST YEAR'S mining and reclamation season, and MUST be paid even if your operation was inactive. <br />The Annual Report and Fee requirement will be considered srtbautted when we have received the' folloiwing :. <br />components: <br />1. APPROPRIATE ANNUAL FEE <br />2. COMPLETED ANNUAL REPORT <br />3. ASSOCIATED MAP as required by rule x r t4 t <br />If ou have requested, reclamation responsrbllrty release from the ,D of Reclamation, Mrmng and Safety r > <br />Total Fee Due: $79l 00 {Due on or',before your uversary pate) T <br />Return the enclosed Annual Report FORM, a MAP, and a CHECK or MONEY ORDER made payable to Division} <br />of Reclamation, Mining and Safety, 1313 Sherman St., Room 215, Denver, CO 80203. If your records indicate <br />these documents and fees have already been submitted, please notify the Division. <br />If you have additional comments and/or information that should be provided to the Division, please provide it below <br />or attach it to this form along with your written report and map. Annual Report instructions are enclosed. If you <br />have any questions, please feel free to contact Michelle Ramirez at (303) -866 -3567 x8114. Thank you for your <br />cooperation in this matter, <br />IF THE ANNUAL FEE SUBMITTALS ARE NOT RECEIVED ON OR BEFORE YOUR ANNIVERSARY <br />DATE, THE ENFORCEMENT PROCESS WILL AUTOMATICALLY BE INIATIED. ENFORCEMENT <br />ACTIONS MAY RESULT IN CIVIL PENALTIES AND /OR REVOCATION OF YOUR PERMIT. <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />