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• iii iiiiiiiuiiii iii - <br />999 <br />STATE OF <br />DIVISION OF MINERALS AND GEOLOGY <br />Depanmenl of NaWral Resources <br />1313 Sherman $1., Room 21 S <br />Derner, Colorado 80203 <br />Phone: 13031866-3567 <br />FAIC: (3031832-8106 <br />Fee Agreement for Self-Assurance <br />The undersigned, pursuant to C.R.S. 1973, 34-32-122(2), as amended, and <br />pursuant to Rule 7.5(f)(1)(2)(3>(4) of the Rules and Regulations of the <br />Colorado Mined Land Reclamation Board for Minerals (Non-Coal) Mining, hereby <br />agrees to be responsible for the actual costs of establishing and reviewing <br />Roy Romer <br />Governor <br />lames 5. Lachhead <br />EYKNIVe DIreC1p <br />Michael 8. Long <br />DivislOn Directp <br />the undersigned's Financial Warranty. The undersigned further understands and <br />agrees that these costs include the initial costs of establishing the <br />Financial Warranty, and also the annual costs of reviewing the Financial <br />Warranty. <br />The undersigned understands and agrees that he shall be responsible for all <br />applicable costs assessed hereunder in an amount and form to be determined by <br />the Board pursuant to C.R.S. 1973, 34-32-122(2), whether or not the Board . <br />issues the permit. <br />The undersigned agrees <br />Mined Land Reclamation <br />to pay thg~e,fees upon presentation of a bill from the <br />Divis~~l~N p 2~~., <br />'If • <br />MM ~/. <br />O <br />~•.9lF;U~.G.O`~Q,P; . <br />MY lsabn Ei~Y~ <br />a9O <br />AG Alpha No. NR LR HVWG <br />AG File No. DNR/6988/LW <br /><Rev. 9/83) <br />Doc. No. 5313 <br />