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AVCOLORADO *4k �,y <br /> Division of Reclamation, ?R/ �b <br /> Mining and Safety <br /> Department of Natural Resources <br /> 1313 Sherman St. Room 215 <br /> Denv�r,CO 80203 <br /> May 1,2017 <br /> G>2� /S <br /> Russell A.Larsen OZO. 080CD <br /> Elam Construction,Inc. <br /> 556 Struthers Ave <br /> Grand Junction,CO 81501-3826 <br /> Gehrman Pit,Permit M-2009-078,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-2009-078 <br /> Operation Name: Gehrman Pit <br /> Anniversary Date: June 29,2017 <br /> Total Fee Due: $791.00(Due on or before your Anniversary Date) <br /> 0.5/1DS/Z01i <br /> �4 <br /> 1313 Sherman St. Room 215 Denver,CO 80203 P(303)866-3567 F I I*f� �+y o, <br /> John W. Hickenlooper, Governor Robert W. Randall, Executive Director I Virginia Brannon, Director <br /> �`1876 % <br />