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Return the enclosed Annual ReOgrt FORM, a MAN, and a C'IIFCK or MONI-N ORDER made payable to: <br />Division of Reclamation. Mining and Safety, 1313 ShernnaS <br />nt., Room 215, Denver, CO 802103. If your <br />records indicate these documents and fees have already been submitted, please notify the Division <br />If you have additional continents 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 yucsilons, please feel free to contact Scottie Tate ((303) 866-3567 ext 3(166), <br />Michelle Ranurez ((303) 806-3567 ext X 114), tlrenlitll dnr (Irnl,,tllttlitdtiltlt(ii ,state.co.tls Thank you tier your <br />cooperation to this matter <br />IF 1-111 .\\\I',\L H-1: SU13\11TTAI S \RI \O I' I'll (11\ 1:1) t)\ OR BI F()RI Y01 R <br />\\\I\'I.RS \R) DATI . 1111 F\I't)R(I \11-:\ 1 I'Rt��'FSS \\ III \l' 1()\I \TV \LLl 13F <br />I\IFIATE 1) I -til ()RCI N11 \1 -\(`Flt)\S \1 \) 1)1-titt I I 1\ l\'ll III \-\I 'I'll S \\I) (1R <br />RIA OCA1 It)\ ()F Y(WR PHZ\11 I <br />