2015-12-08_REPORT - M2006039

• Permit No: M2006039
• IBM Index Class Name: Report
• Doc Date: 12/8/2015
• From: North Clear Creek Construction
• To: DRMS
• Annual Report Year: 2014
• Permit Index Doc Type: Annual Fee/Report
• Email Name: ACY
• Media Type: D
• Archive: No

DIVISION OF RECLAMATION,MINING AND SAFETY
Department of Natural Resources
1313 Sherman St.. Room 215 C O L O R A D O
Denver,Colorado 80203 DIV r s l o r. Ia F
RECLAMATION
Phone:[phone] M I N I t4(,
FAX:[phone]
SAFETY
November 3, 2014 John W.Hickenlooper
Governor
Mike King
,lulre histus Executive Directo•
Chevron Shale Oil Company,a division of Choxon USA, Inc. virgi�ia Brannon
760 Horizon Drive Suite 412 Director
Grand Junction,CO 81506
North Clear Creek Construction Materials Mine, Permit N'l-2006-039, Annual Free Invoice and
Report Regncst
PI.E:-ASE READ C'AREFUI,LI'— ACTION REQUIRED
Please attach Sour C(011PLETED srritten Annual Report and Annual Report N1ap to this form
Under the terns of your NO[or Reclamation Permit and Colorado Statutes,you must submit Annual Fees and
Annual Reports(including a map). You must pay the Annual Fee and submit an Annual Report each year until
reclamation responsibility release is granted. The Annual Fee is not a renewal ie.c. The Fee and Report are fi r
LAST YEAR'S mining and reclamation season.and MUST he paid even if your operation was inactive.
The Annual Report and Fee requirement will be considered submitted wheti we have received the following
components:
1. APPROPRIATE.ANNUAI. FE'Ed
2. COMPLETED ANNUAL REPORT
3. ASSOCIATED NtAP as required bj rule
If you have requested reclamation responsibility release from the Division of Reclamation,Mining and Safety
("Division")but your permit is not released by the anniversary date listed below,the Annual Fee MUST be paid. If
the permit is released before the anniversary date,then by Statute,it is not necessary to pay an Annual Fee or submit
an Annual Report for that year.
Division records indicate the$323.00 fee is due for the hollowing:
Permit: M-2006-039
Operation Name: North Clear Creek Construction Materials Mine
Anniversary Date: December 8,2014
Total Fee Due: S323.00(Due on or before your Anniversary Date)
Return the enclosed Annual Report FORM,a MAP,and a CHECK or MONEY ORDER made payable to: Division
of Reclamation, Mining and Safety, 1313 Sherman St.. Room 215. Denver,CO 80203. if your records indicate
these documents and fees have already been submitted,please notify the Division.
If you have additional comments and/or information that should be provided to the Division,please provide it below
or attach it to this form along with your written report and map. Annual Report instructions are enclosed. If you
have any questions,please feel free to contact Michelle Ramirez(303)860-3567 ext 8114. Thank you for your
cooperation in this matter.
11 111 F ANNIiAI. FEE SUBMiTTALS ARF Nt)T RL(TI VI 1)ON OR lil-FOR1 W('R ANNIVI-RS N10'
D\I I . I Ill- FNH)RCEMEN'i PROCFSS WII_I_ AUTON1:A I WAI.I N' lil- INIAIIFD. FNHW.T%1f,N I
A( I IUN�s MAY R'S TIN CIVIL Pi-NAl 1lFS AN(J�)1iItJ_A C)(:-AFIUN �?h 1'OUK P[RMIJ.
Office of
Office of
Mined Land Reclamation Denver-Grand Junction- Durango Active and inactive Mines