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COLORADO <br /> Division of Reclamation, <br /> AV Mining and Safety <br /> Department of Natural Resourcvs <br /> Cli Co <br /> June 1, 2017 <br /> I <br /> Fred J.Orr <br /> Baculite Mesa. 1-1-C <br /> 5040 Aconia Street <br /> Denwr,CO 8021620 10 <br /> Baculite Mesa Pit, Permit N11-1997-01 1,Annual Fee In-mice and Report Request <br /> PLEASE READ <br /> AD CARIA-41AN—ACTION RFQ1jIRI-:I) <br /> Please attach votir-COMPLEA]"D written Annual Report and Annual Report INIal) to this form <br /> Under the terms 0fV0LIr Reclamation Permit and Colorado Statutes. VOLI must submit an Annual Fee and <br /> Annual Report (including a n)ap). You I11LISt 1),I\ the Annual Fee and subn1it 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 MUS'I be paid even it'your 0pCI-atI0n \\as <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 /> Safetv ("Division") but your permit Is not released by the anniversarN date listed below. the Annual Fee <br /> MUST be paid. Ifthe permit is released before the anni\,ersarN date. then by Statute, it is not necessarN, to <br /> pay an Annual Fee Or submit an Annual Report for that year. <br /> Division records indicate the $79 1.00 I'ee is CILIC for the l'olloWin": <br /> Permit: M-1997-011 <br /> Operation Name: BaCLIlitC Mesa Pit <br /> AnniversarN, Date: July 9,2017 <br /> Total Fee 6LIC: $79 1.00(Due on or before your Anniversary Date) <br /> C' ., -Iw <br />