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Page 2 of 5 <br /> Return the enclosed Annual Renori FORM_.a M.,V. wid a CHECK or MONEY ORDER made payable to: <br /> Division of Reclamation. Mining ans Safety. 1313 Sherman St., Room 215, 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 comments 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 fee;, free to contact Scottie Tate ((303) 866-3567 ext 8166), <br /> Michelle Ramirez((303)866-3567 ext 8114),or email dnr-.drr.,,srninadmin(&.state.co.us. Thank you for your <br /> cooperation in this matter. <br /> IF THE ANNUAL FEI SUBMIT"i'ALS ARE NOT RECEIVED ON OR BEFORE YOUR <br /> ANNIVERSARY DATE, THE ENFORCEMENT PROCESS W`1 AUTOMATICALLY BE <br /> i ITIATED. Eiji 3R ;?�"IE �T �l 1.i%1 VJ ivirlY i�cSu�.T i t iVIL PENALTIES AND/OR <br /> REVOCATION OF YOUR PERMIT. <br />