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IMM COLORADO <br /> IFTW <br /> t Division of Reclamation, <br /> w Mining and Safety <br /> Department of Natural Resources <br /> 1313 Sherman St.Room 215 <br /> Denver,CO 80203 <br /> May 1,2017 <br /> Albert R.Frei <br /> Albert Frei&Sons Inc. <br /> P.O.Box 700 <br /> Henderson,CO 80640-0700 <br /> Walstrum Mine,Permit M-1983-033,Annual Fee Invoice and Report Request <br /> PLEASE READ CAREFULLY—ACTION REQUIRED <br /> Please attach your COMPLETED written Annual Report and Annual Report Map to this form <br /> Under the terms of your Reclamation Permit and Colorado Statutes,you must submit an Annual Fee and <br /> Annual Report(including a map). You must pay the Annual Fee and submit an Annual Report each year <br /> until reclamation responsibility release is granted. The Annual Fee is not a renewal fee. The Fee and Report <br /> are for LAST YEAR'S mining and reclamation season, and MUST be paid even if your operation was <br /> inactive. <br /> The Annual Report and Fee requirement will be considered submitted when we have received the <br /> following components: <br /> 1. APPROPRIATE ANNUAL FEE <br /> 2. COMPLETED ANNUAL REPORT <br /> 3. ASSOCIATED MAP as required by rule <br /> If you have requested reclamation responsibility release from the Division of Reclamation, Mining and <br /> Safety ("Division") but your permit is not released by the anniversary date listed below, the Annual Fee <br /> MUST be paid. If the permit is released before the anniversary date,then by Statute,it is not necessary to <br /> pay an Annual Fee or submit an Annual Report for that year. <br /> Division records indicate the$791.00 fee is due for the following: <br /> Permit: M-1983-033 <br /> Operation Name: Walstrum Mine <br /> Anniversary Date: June 23,2017 <br /> Total Fee Due; $791.00(Due on or before your Anniversary Date) <br /> 1313 Sherman St.Room 215 Denver,CO 80203 P(303)866.3567 f <br /> John W. Hickentooper,Governor I Robert W.Randall,Executive Director i Virginia Brannon,Director * „ r <br />