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COLORADO <br /> Division of Reclamation, <br /> Mining and Safety <br /> Department of,Natural Resou-ces <br /> 1313 Sherman St.Room 215 <br /> Denver, CO 80203 <br /> August 1, 2017 <br /> Dean Ormiston <br /> Baca County <br /> 741 Main St.,Suite 1 <br /> Springfield,CO 81073 <br /> Gravel Pit No 8,Permit M-1977-485,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-1977485 <br /> Operation Name: Gravel Pit No 8 <br /> Anniversary Date: September 11,2017 <br /> Total Fee Due: $791.00(Due on or before your Anniversary Date) <br /> 1313 Sherman St. Room 215 Denver,CO 80203 P(303)866-3567 F <br /> John W. Hickenlooper,Governor I Robert W. Randall, Executive Director I Virginia Brannon, Director <br />