2015-05-01_REPORT - M2013013

• Permit No: M2013013
• IBM Index Class Name: Report
• Doc Date: 5/1/2015
• Doc Name: Annual Fee/Report Notice
• From: DRMS
• To: Operator
• Annual Report Year: 2015
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources

1313 Sherman St., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
Office of Office of
Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines
John W. Hickenlooper
Governor

Mike King
Executive Director

Virginia Brannon
Director

Under the terms of your NOI 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 fee. The Fee and Report are for
LAST YEAR’S mining and reclamation season, and MUST be paid even if your operation was inactive.

The Annual Report and Fee requirement will be considered submitted when we have received the following
components:

1. APPROPRIATE ANNUAL FEE
2. COMPLETED ANNUAL REPORT
3. ASSOCIATED MAP as required by rule

If you have requested reclamation responsibility release from the Division of Reclamation, Mining and Safety (the
“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 $791.00 fee is due for the following:
Permit: M-2013-013
Operation Name: Cook Pit
Anniversary Date: June 18, 2015
Total Fee Due: $791.00 (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 [phone] ext 8114. Thank you for your
cooperation in this matter.

IF THE ANNUAL FEE SUBMITTALS ARE NOT RECEIVED ON OR BEFORE YOUR ANNIVERSARY
DATE, THE ENFORCEMENT PROCESS WILL BE AUTOMATICALLY INIATIED. ENFORCMENT
ACTIONS MAY RESULT IN CIVIL PENALTIES AND/OR REVOCATION OF YOUR PERMIT.
Bob Basher
Delta County
501 Palmer St., Ste. 227
Delta, CO 81416
May 1, 2015
Cook Pit, Permit M-2013-013, Annual Fee Invoice and Report Request

PLEASE READ CAREFULLY – ACTION REQUIRED
Please attach your COMPLETED written Annual Report and Annual Report Map to this form