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1M� <br /> RECEIVED REV`1=1X1FD <br /> COLORADO AUG 242016 <br /> DIV1bjUN c.:---• RECLAMATION, AUG 0 5 2016 <br /> Division of Reclamation, G&SAFETY LS <br /> Mining and Safety FEE AAP DIVISION OF RECLAMATION <br /> Department of Natural Resources <br /> 1313 Sherman St. Room 215 <br /> RECEIVED MINING AND SAFETY <br /> Denver, CO 80203 AUG 05 2016 <br /> May 31, 2016 DIVISION tJsr-;Z,LAAMATION <br /> MINING S SAFETY-MINERAII <br /> M1W REE+C1Rj <br /> Frances A.Phillips jo 4tkLq <br /> (/Phillips Stone Company,Inc. f <br /> 7850 Ute Hwy <br /> Longmont,CO 80503 <br /> a � Q <br /> Phillips Stone Company,Permit M-1981-075,Annual Fee Invoice and Report Request <br /> PLEASE READ CAREFULLY—ACTION REQUIRED <br /> Please attach your COMPLETED written Annual Report and Annual Report May to this form <br /> Under the terms of your Reclamation Permit and Colorado Statutes, you must submit an Annual Fee and Annual <br /> Report(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 /> 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 the$323.00 fee is due for the following: <br /> Permit: M-1981-075 <br /> Operation Name: Phillips Stone Company <br /> Anniversary Date: July 30,2016 <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 these <br /> documents and fees have already been submitted,please notify the Division. <br /> oF.co, <br /> aw` <br /> 1313 Sherman St. Room 215 Denver,CO 80203 P(303)866-3567 F <br /> John W. Hickenlooper, Governor I Robert W. Randall, Executive Director I Virginia Brannon, Director # <br /> *1876 <br />