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COLORADO <br /> Division of Reclamation, <br /> Mining and Safety <br /> Department of Natural Resources <br /> 1313 Sherman St. Room 215 <br /> Denver, CO 80203 <br /> January 2, 2017 <br /> Dennis Sanchez <br /> Colorado Department of Transportation <br /> 260 Ranney St. <br /> Craig,CO 81625 <br /> N Of Douglas Pass,Permit M-1981-043,Annual Fee Invoice and Report Request <br /> PLEASE READ CAREFULLY—ACTION REQUIRED <br /> Please attach your COMPLETED vs,ritten Annual Report and Annual Report Man to this form <br /> Under the terms of your Reclamation Permit and Colorado Statutes, you must submit an Annual Fee and <br /> Annual Report(including a map). You must pay the Annual Fee and submit an Annual Report each year <br /> until reclamation responsibility release is granted. The Annual Fee is not a renewal fee. The Fee and Report <br /> are for LAST YEAR'S mining and reclamation season, and MUST be paid even if your operation was <br /> inactive. <br /> The Annual Report and Fee requirement will be considered submitted when we have received the <br /> following 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 <br /> Safety(the"Division")but your permit is not released by the anniversary date listed below,the Annual Fee <br /> MUST be paid. If the permit is released before the anniversary date,then by Statute, it is not necessary to <br /> pay an Annual Fee or submit an Annual Report for that year. <br /> Division records indicate the $323.00 fee is due for the following: <br /> Permit: M-1981-043 <br /> Operation Name: N Of Douglas Pass <br /> Anniversary Date: February 1,2017 <br /> Total Fee Due: $323.00(Due on or before your Anniversary Date) <br /> or'cc�. <br /> 1313 Sherman St. Room 215 Denver,CO 80203 P(303)866-3567 F ( t"�• r, <br /> John W. Hickenlooper,Governor I Robert W. Randall, Executive Director I Virginia Brannon, Director <br /> 1876 ; <br />