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w <br /> Return the enclosed Annual Report FORM, a MAP. and a('I lFCK or MONh,Y ORDFA made payable to <br /> Division of Reclamation, Mining and Safety. 1313 Sherman St., Room 215. Denver, CO 90203. li'your <br /> records indicate these documents and tees lime already been submitted, please notify the Dlvi%lOn. <br /> Ifyou 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 'Fate (003) 860-3567 ext 8166). <br /> Michelle Ramirez 003)860-3W ext K 114).or email dnr drntsnunadntin(a state.coms. Thank you to► your <br /> cooperation in this matter. <br /> 11 1111 \\\t,Al I I F st,BMIT IAI S, \ltl \O! Itl c I I\ 1 U O\ OR HI I ORI Y(WR <br /> ,\N\I\'I RSARY I)A,FI , I III L\I ORCI I \ 1 1)R CI I SS W I L I \1I P AIATICALLY lil <br /> I\I I I \ I 1 1) I \I OK('I \1k \ 1 ACI 10\` \1 \1 R1 till I I\ l IVII PIAAt l IF.S \\I) Ok <br /> I Z I \ ( tt' \I 0\ ()l- Y t R t'I R N I I I <br />