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Pogo of <br />Return the enclosed Anrtjpl Report FQ_RNI, a MAP, and a CHECK or MONEY ORDER made payable to <br />Divi5iun or 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 nolifv the Division <br />1f 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 %aTitlen report and map. Annual Report instructions are <br />enclosed. If you have any questions, please feet free to cunizict Scottie Tate ((303) 866-3567 ext 8166), <br />Michell, Ramirez ((303)866-3567ext 8H4), oremail dnr drTnsminadmin us(ate,co.us. Thankyou for your <br />cooperation in this rnattcr. <br />If THE ANNUAL ISLE SUBMITI'ALS ARE NOT RLCEIVED ON OR BEFORE YOi,,R <br />ANNIVERSARY DATE, THE ENFORCEMENT PROCESS WILL AUTOMATICALLY BY <br />INITP,TED ENroiCEN.11=-N'i ACE IONS 'OAN' RESULT IN CIVIL PENALTIES AND OR <br />IZCVOCAI*10\'OF YOUR PI. RMIT <br />