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Page 2 ofj <br /> Return the enclosed Annual Report FORM,a MAP,and a CHECK or MONEY ORDER made payable to: <br /> Division of Reclamation, Mining and Safety, 1313 Sherman St., Room 21.5, Denver,CO 80203. If your <br /> records indicate these documents and fees have already been submitted,please notify the Division. <br /> If you have additional conuDpyits and/or information,that should be provided to the Division,please provide <br /> it below or attach it to this form along with your written report and map. Annual Report instructions are <br /> enclosed. If you have any questions, please feel free to contact Scottie Tate ((303) 866-3567 ext 8166), <br /> Michelle Ramirez((303)866-3567 ext 8114),or email dnr_drmsminadmin@state.co.us. Thank you for your <br /> cooperation in this matter. <br /> IF THE ANNUAL FEE SUBMITTALS ARE NOT RECEIVED ON OR BEFORE YOUR <br /> ANNIVERSARY DATE, THE ENFORCEMENT PROCESS WILL BE AUTOMATICALLY <br /> INITIATED. ENFORCEMENT ACTIONS MAY RESULT IN CIVIL PENALTIES AND/OR <br /> REVOCATION OF YOUR PERMIT. <br />