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RECEIVED <br /> JUL 0 5 2017 <br /> COLORADO <br /> Division of Reclamation, <br /> Mining and Safety <br /> Department of Natural Resources <br /> 1313 Sherman St. Room 215 <br /> Denver, CO 80203 <br /> July 3,2017 <br /> Russell A.Larsen <br /> Elam Construction,Inc.dba Sandco,Inc. <br /> 556 Struthers Ave. <br /> Grand Junction,CO 81501-3826 <br /> Willow Bend,Permit M-1986-165,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 $323.00 fee is due for the following: <br /> Permit: M-1986-165 <br /> Operation Name: Willow Bend <br /> Anniversary Date: August 27,2017 <br /> Total Fee Due: /1323.00(Due on or before your Anniversary Date) <br /> no9Z3 <br /> 0,z,0 ��©©o <br /> U <br /> pF.COz <br /> �e <br /> 1313 Sherman St. Room 215 Denver,CO 80203 P (303)866-3567 F I I"h O' <br /> John W Hukentooper, Governor I Robert W. Randall, Exenrtrve Director J Virginia Brannon. Director - <br /> *1876 ;" <br />