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AV COLORADO <br />Division of Reclamation, <br />-Mining and Safety <br />Department of Natural Resources <br />1 1,1 3 11,11, 1,71,,1, �,f r1,;. , , <br />Der.: - CO i3 t: ti -1. <br />November 1, 2017 <br />Vince Guinta <br />Chevron Shale Oil Company, a division of Chevron USA, Inc. <br />760 Horizon Drive Suite 412 <br />Grand Junction, CO 81506 <br />North Clear Creek Construction Materials Mine, Permit M-2006-039, Annual Fee Invoice and Report <br />Request <br />1TFAk,L RLAD ( .Utl:i1't'LL - -1CTIO\ RE01 IRF) <br />Please attach Hour (,0NIPLE I FD i� ritten .Annual Report mid .-annual Report 11ap t+r thi" 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 vour 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-2006-039 <br />Operation Name: North Clear Creek Construction Materials Mine <br />Anniversary Date: December 8. 2017 <br />Total Fee Due: $323.00 (Due on or before your Anniversary Date) <br />1313 Shernian St Rocco 215 D-nv,,r CO 30203 P 13031 866 3567 F <br />)r,hn W HtcEonloop,-r Gowrnnr I Rr,ht'rt W Randall. EraaUtlQ Ditecl,)r Vwjmla Brannen Drn,ct^r <br />