Laserfiche WebLink
NOI NAME: <br />NOI NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />On the anniversary date of the Notice of Intent (NOI), the operator must submit the annual fee. <br />Division records indicate the following NOI contact information. Please verify and make any necessary changes: <br />A L L h �� .Jc e <br />Explorer Contact: <br />Explorer Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form. We thank you for your attention to this matter. <br />elAli <br />Date <br />ANNUAL FEE AND REQUEST FOR UPDATE OF INFORMATION <br />Roger L. Day <br />American Shale Oil, LLC <br />110 E. 3rd Street, Suite 210 <br />P O Box 1470 <br />Rifle, CO 81650 <br />(970) 625 -4324 <br />(970) 625 -4318 <br />.e YfD �. <br />Corporate Officer Owner, or esi <br />Signature of Corp gn ee <br />M: \OSS\MRI\ANNFEE\ LETTERI OCT- 2011 -P\P- 2008 -046 FI.DOC <br />American Shale Oil, LLC <br />P- 2008 -046 <br />AMSO RD &D Project -Phase 1 <br />October 21, 2011 <br />$86.00 (Due on or before your anniversary date) <br />Rio Blanco <br />RECEIVED <br />s/SEP 9 201i <br />e Division of Neclamation, <br />Mining and Safety <br />