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AVCOLORADO <br />Division of Reclamation, <br />Mining and Safety <br />31 3 Strennan St. Room 71'r <br />Donvr,r ( 80201 <br />September 1, 2016 <br />Julie Sevier <br />Pioneer Sand Company, Inc. <br />P.O. Box 7650 <br />Colorado Springs, CO 80933-7650 <br />Ingleside Quarry, Permit M -1980 -037 -HR, Annual Fee Invoice and Report Request <br />PLL kSE 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 Pennit 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. APPROPRIATL 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 -1980 -037 -HR <br />Operation Name: Ingleside Quarry <br />Anniversary Date: October 1, 2016 <br />Total Fee Due: $791.00 ( Due on or before your Anniversary Date) <br />1.31 3 Shrnn,w St. Room 215 Dr sivci . CO 80203 P 11031 866-3567 1 <br />John W. Hrckenlooper, t,ovon,oi Rnhrrl N,` Rand7U, Lxe�:uUve Dnectrn Vtrpwi Brannon, DrfeLlor <br />