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COLORADO <br /> Division of Reclamation, <br /> Mining and Safety <br /> September 1,2017 <br /> Bradley Dallmn <br /> The City of Lafayette <br /> 3290 South Public Road <br /> Lafayette,CO 8002E-2706 <br /> Goose Haven Reservoir#2-Complex Expansion,Permit M-2010-071,Annual Fee Invoice and Report <br /> Request <br /> PLEASE RV AD CALPF,FULLY ACTION REQUIRED <br /> Please attach your COMPLETED written Annual Report and Annual Report 'Matt to this forin <br /> Under the terms of your Reclamation Permit and Colorado Statutes,you roust submit an Annual Tee and <br /> Annual Report(inclUding a map). You must pay the Annual Fee and submit an Annual Report each year <br /> until reclamation responsibility relea,e is granted. -rhe Annual Fee is not a renewal fee., The Fee and Report <br /> are for LAST Yf AR'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. CONIPLETED ANNUAL REPORT <br /> 3. ASSOCIATED MAP as required by rule <br /> If you have requested reclamation responsibility retease from the Division of Reclamation, Mining and <br /> Safety(the"Division")but your permir is not released by the anniversary date listed below.the Annual FCC! <br /> MUST be paid. if the permit is released before the anniversary date,then by Statute, it is not accessary to <br /> pay an Ammar 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-2010-071 <br /> Operation Name: Goose Haven Resetioir rl2-CwTiplex Expansion <br /> Anniversary Date: October 18,2017 <br /> Total Fee Due: $791.00(Due on or before your Anniversary Date) <br /> of �0t,- <br />