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STATE OF COLORADO <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> Department of Natural Resources <br /> 1313 Sherman St.,Room 215 O L O R A D O D <br /> Denver,Colorado 80203 DIVISION o F <br /> Phone:(303)866-3567 RECEIVED RECLAMATION <br /> MINING <br /> FAX:(303)832-8106 <br /> SEP 2 62014 SAFETY <br /> August 1,2014 John W.Hickenlooper <br /> Governor <br /> pivision fo Reclamation, <br /> Mining r& Safety Mike King <br /> Thomas J. - Executive Director <br /> Lakewood Brick&Tile Company Loretta E.Pineda <br /> 1325 Jay St.t Director <br /> Lakewood,CO 0214 <br /> Doughty's Pit,Permit M-1975-009,Annual Fee Invoice and Report Request <br /> PLEASE READ CA EFULLY—ACTION REQUIRED <br /> Please attach your COMPLETED writt n 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 submitted when we have received the following <br /> components: <br /> 1. APPROPRIATE ANNUAL FEE <br /> 2. COMPLETED ANNUAL REPORT <br /> 3. ASSOCIATED MAP as required by rule <br /> If you have requested reclamation responsibility release from the Division of Reclamation,Mining and Safety <br /> ("Division")but your permit is not released by the anniversary date listed below,the Annual Fee MUST be paid. If <br /> the permit is released before the anniversary date,then by Statute,it is not necessary to pay an Annual Fee or submit <br /> an Annual Report for that year. <br /> Division records indicate e$323.00 fee is due for the following: <br /> Permit: M-1975-009 <br /> Operation Name: Doughty's Pit <br /> Anniversary Date: September 30,2014 <br /> Total Fee Due: $323.00(Due on or before your Anniversary Date) <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 Jim Dupler(303)866-3567 x8119 or Christine Brookshire(303)866- <br /> 3567 x8132. Thank you for your 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 PENALTI S AND/OR REVOCATION OF YOUR PERMIT. <br /> Office of Office of <br /> Mined Land Reclamation Denver•Grand Junction•Durango Active and Inactive Mines <br />