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COLORADO <br />Division of Reclamation, <br />Mining and Safety <br />Department of Natural Resources <br />1313 Sherman St. Room 215 <br />Denver, CO 80203 <br />September 1, 2015 <br />Patrick C. Siglin <br />Black Range Minerals Colorado, LLC <br />110 N. Rubey Drive, Suite 201 <br />Golden, CO 80403 <br />Hansen Uranium Project, Permit P-2009-025, Annual Fee Invoice and Report Request <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 and Colorado Statutes, you must submit an Annual Fee and Annual Report <br />(including a map). You must pay the Annual Fee and submit an Annual Report each year until reclamation <br />responsibility release is granted. The Annual Fee is not a renewal fee. The Fee and Report are for LAST YEAR'S <br />exploration 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 <br />following components: <br />1. ANNUAL FEE ($86) <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. <br />If the permit is released before the anniversary date, then by Statute, it is not necessary to pay an Annual Fee or <br />submit an Annual Report for that year. Division records indicate the $86.00 fee is due for the following NOI(s) <br />on or before the Anniversary Date: <br />Permit: P-2009-025 <br />Operation Name: Hansen Uranium Project <br />Anniversary Date: October 7, 2015 <br />Total Fee Due: $86.00 (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: <br />Division of Reclamation, Mining and Safety, 1313 Sherman St., Room 215, Denver, CO 80203. If your records <br />indicate these documents and fees have already been submitted, please notify the Division. <br />Ok COLO <br />1313 Sherman St. Room 215 Denver, CO 80203 P (303) 866-3567 F I � <br />John W. Hickenlooper, Governor I Mike King, Executive Director I Loretta E. Pineda, Director + <br />