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COLORADO <br /> Division of Reciarnatton. <br /> • Mining and Safety <br /> 1313 Sherman St.Roam 215 <br /> Denver. CO 80203 <br /> May 31,2016 <br /> Fred 1.Orr <br /> Baculite Mesa,LLC <br /> 5040 ACOrna Street <br /> Denver.CO 80216-2010 <br /> Baculite Mesa Pit,Permit M-1997-011,Annual Fee Invoice and Report Request <br /> PLEASE READ CAREFULLY—ACTIO" REQUIRED <br /> Please attach your COMPLETED written Annual Re rt and Annual Report NIa to this forntnual <br /> Fee and <br /> Report each year until reclamation <br /> t S <br /> Under the terms of your Reclamation Permit An An <br /> nual Fee and submit an Annual Repot an Ann lr LAST YEARS <br /> Report(including a map). You must pay the <br /> responsibility release is granted. The Annual Fee aid snot if enew your operation hwas inactive-eport are to <br /> al <br /> mining and reclamation season.and MUST be p <br /> The Annual Report and Fee requirement will be considered submitted when we have received the following <br /> components: <br /> 1, APPROPRIATE AISNUAL FEE <br /> 2, COMP1-EYED ANNUAL REPORT <br /> 3, ASSOCIATED MAP as required by rule <br /> id_ If <br /> Reclamation, Mining and Safety <br /> If you have requested reclamation responsibility release o� Division <br /> bclow�the Annual Fee MUST be paubm t <br /> Permit is not released by the anniversary an Annual Fee or <br /> ("Division')but your p� <br /> the permit is released before the anniversary date,then by Statute,it is not necessary to pay <br /> an Annual Report for that year_ <br /> Division records indicate the i91.�l'e is due for the following: <br /> openPermit: Baculite Mesa Pit <br /> Operation Name: 1u1 q,2016 <br /> Anniversary Date: y <br /> Total Fee Due: S791.00(Due on or before your Anniversary ate <br /> Return the enclosed <br /> Ann.�a1 gW! FORM,a <br /> MAP,and a CHECK or MONEY ORDER made payable to: Division <br /> of Reclamation,Mining and Safety. 13 t 3 Sherman . Room 215,De <br /> fy the Division. <br /> Co 80203. If your records indicate these <br /> documents and fees have already been submitted,Please <br /> �a ; <br /> le <br /> rman St. Room 215 Denver,CO 8020' P l3031 866 3567 F <br /> 1313 She ` <br /> John W. Hickenlooper. Governor ! Robert W. Randall, Executrve Director 1 Virginia(irannon. Director <br />