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Page 2 of 5 <br /> Return the enclosed Annual Report FORM, a MAP, and a CHECK or MONEY ORDER made payable to: <br /> Division of 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 notify the Division. <br /> If 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 written report and map. Annual Report instructions are <br /> enclosed. If you have any questions, please feel free to contact Scottie Tate ((303) 866-3567 ext 8166), <br /> Michelle Ramirez((303)866-3567 ext 8114).or email dnr—drmsminadmin(iistate.co.us. Thank you for your <br /> cooperation in this matter. <br /> It' HII A\WAI 1 + tit 13\111 JAI ', 1R1 \( )[ O\ ()R BI°, -010- ' ()1'It <br /> ANNI 1RSAR1 D- TFI 1 III 1-M ORCIAIIA 1 I'IMCI SS M 1[.I M At'1`t) IA] I(. ALI ) <br /> IN]I-11[11.1) [A OW '11\11 \I I1()\S NI 31 1<1 1-11 1 1 1\ ( IVII 111 AI [II ti A\D (-)1t <br /> R! \, ()t t 1 1r e11; t )1 1'(`i '!t W 11 V! 1 <br />