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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 <br /> records indicate these documents and fees have already been submitted,please notify the Division. <br /> If you have additional comments and/or information that should be provided to the Division,please provide <br /> it below or attach it to this form along with your written report and map. Annual Report instructions are <br /> enclosed. If you have any questions, please feel free to contact Scottie Tate ((303) 866-3567 ext 8166), <br /> Michelle Ramirez((303)866-3567 ext 8114),or email dnr_drmsminadmin@state.co.us. Thank you for your <br /> cooperation in this matter. <br /> :F TA NNIIA? FEi= 'ITBI T`_U. : ARE NOT R=t LIB': 7.1NT C►R BEFORL 1.,_1R <br /> aTiN RS,-.iz D`<T„ 71- E -\IFC_;:t'F\47\T 1 L; 1� ii E. ^;,TO `t' 3F <br /> ;NF .. ' tJ. L: -FORCL,"OLVI AC', ON [CIA zFSIJL . 1�. Cif -`t.'A 1' L `_j Z <br /> RE_V0('ATIt)\I <br />