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Page 2 of 5 <br /> 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 /> If 'IHF .ANNUAL. FEE SUBN111'TALS ARL NOT RECEIVLD ON OR BEFORE YOUR <br /> .ANNIVERSARY DATE. THE ENFORCF,\IEN'T PROCESS WILL BE AUTOMATICALLY <br /> INITIATED. E_NFORCFMENT AC-110NS MAY RESIN T 1N CIVIL PENALTIES ANDIOR <br /> RL VOCATION OF YOUR PF..RMI1. <br />