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�® COLORADO <br />Division of Reclamation, <br />Mining and Safety <br />Department of Natural Resources <br />LDisclaimer <br />Uaderthe team of your NOI or Reclamation Pemtit and Colorado Statutes, you trust submit Annual Fees and Annual Reports (including a <br />map). You must pay the Annual Fee and submit an Annual Report each year until reclamation responsibility release is granted. The Annual <br />Fee is not a renewal fee. The Fee and Report are for LAST YEAR'S raining and reclamation season, and MUST be paid even if your operation <br />VMS inactive. <br />Ifyou have requested reclamation responsibility release fromthe Division of Reclamation, Mining and Safety ("Division") but your perarit is <br />not released by the anniversary date listed below, the Annual Fee MUST be paid. If the permit is released before the anniversary date, then <br />by Statute, it is not necessary to pay an Annual Fee or submit an Annual Report forthat year. <br />Division records indicate the following is due: <br />Select Permit Number* <br />Only Permit Numbers with currently due Annual Fees will be listed. If the Permit Number Is not listed, then the Annual Fees are not <br />due, the Permit Number has already been submitted, or the Permit Number Annual Fee payment has been processed. <br />M1978314 <br />Select Anniversary Date* <br />11-22-2018 <br />PLEASE REMEMBER TO CLICK 'SUBMIT' AFTER YOU HAVE COMPLETED YOUR REPORT Alm PAYMENT. <br />Please check the box indicating you have read and understand the terms of the Annual Report and <br />Annual Fee * <br />17 i understand and agree to the temts <br />General Information <br />Permittee Name <br />Hevms Family LLLP <br />Operation Name <br />Wng Mountain Sand & Gravel Mine <br />Permit Number Fee Due Permit Acreage <br />M1978314 791.00 341.00 <br />County Anniversary Date Current Bond Amount <br />Routt 11-22,2018 86090.00 <br />Permittee Contact Information <br />Permitting Contact Name <br />Frank Revues <br />