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COLORADO <br />Division of Reclamation, <br />Mining and Safety <br />Department of Natural Resources <br />13 t 3 tihei man St Room 215 <br />0-nvr_r. CO 80? -03 <br />June 1, 2017 <br />Peter L. Dawson <br />Baca County <br />741 Main St.,Suite 1 <br />Springfield, CO 81073 <br />Bulkley Pit No 17, Permit M-1981-138, 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 (the "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-1981-138 <br />Operation Name: Bulkley Pit No 17 <br />Anniversary Date: July 24, 2017 <br />Total Fee Due: $791.00 (Due on or before your Anniversary Date) <br />13I ; .,hei man `.,t. Room L 1 `i Denve, . CO 80203 P 13031 8u6-35oi F <br />uhn W Hie.�entoupei. Governor I Robert W, Randall, Executive Director I Viromia 6Eannon, Difector <br />