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ICOLORAQQ Division of Reclamation, -AV Mining and Safety Denartment of t,latwai Resource, 1313 Sherman St.Room 215 Denver,CO 80203 August 1,2016 James S.Miner Builder's Aggregate,Inc. 510 Dahlia St. Fort Morgan,CO 80701 Builders Aggr Pit,Permit M-1981-112,Annual Fee Invoice and Report Request PLEASE READ CAREFULLY— I DQUIRED Please_attach vour COMPLETED written Annual Report and Annual Retort Mao 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 ("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$791.00 fee is due for the following: Permit: M-1981-112 Operation Name: Builders Aggr Pit Anniversary Date: September 1,2016 Total Fee Due: $791.00(Due on or before your Anniversary Date) • oe;�o p. 1313 Sherman St. Room 215 Denver,CO 80203 P(303)866-3567 F John W. Hickenlooper,Governor I Robert W. Randall,Executive Director I Virginia Brannon,Director # *' . —f 1876