2017-02-08_REPORT - M1985170 - Laserfiche WebLink

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V E'VE JAN 0 9 2017 COLORA, DO s Division of Reclamation, BY- Mining and Safety Department of Natural Resources t 1313 Sherman St.Room 215 t'Je' �� 7aod sa 98 y Denver,CO 80203 , January 2,2017 I hereby certify that I have received the goods or services listed hereon, that I have carefully Inspected weighed, counted or Kane Schneider measured the commodities and found tl,errt to condition Colorado Department of Transportation and complying with the specifications given or ,°0dat the goods 1 p° and servK.eF are in contract compiler=,or hat the services 606 S.9th St. were,_ati factory ex pt s noted. Grand Junction,CO 81501 4 Date receeved Slanat-ure of Nerpon accepting goodslsenrices Patrol# Print Name Cost Cantor Obj. Sub. Function BLM Burnt Shale Pit,Permit M-1985-170,Annual Fee Invoice and Report Request PLEASE READ CAREFULLY—ACTION REQUIRED Please attach your COMPLETED written Annual Reuort and Annual Report Mal)to this form Under the terms of your Reclamation Permit and Colorado Statutes,you must submit an Annual Fee and Annual Report(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$323.00 fee is due for the following: Permit: M-1985-170 Operation Name: BLM Burnt Shale Pit Anniversary Date: February 1,2017 Total Fee Due: $323.00(Due on or before your Anniversary Date) Iwo C°<o 1313 Sherman St.Room 215 Denver CO 80203 P(303)866.3567 F r" John W. Hickenlooper,Governor I Robert W.Randall,Executive Director I Virginia Brannon, Director �. k, ,.