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DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866 -3567 <br />FAX: (303) 832 -8106 <br />February 1, 2012 <br />Clyde and Marie Couch <br />122 State St. <br />Sterling, CO 80751 <br />are necessa then no new ma <br />Annual Report. <br />If you have requested reclamation <br />"Division ") but your permit is not <br />the permit is released before the <br />annual report for that year <br />Permit No.: <br />Operation Name: <br />Anniversary Date: <br />Total Fee Due: <br />Office of <br />Mined Land Reclamation <br />Denver • Grand Junction • Durango <br />STATE OF COLORADO <br />COLORADO <br />D I V I S I O N O F <br />RECLAMATION <br />MINING <br />— &— <br />SAFETY <br />MINED LAND RECLAMATION BOARD <br />110c ANNUAL FEE INVOICE AND REPORT RE UEST <br />PLEASE READ CAREFULLY <br />Under the terms of your Reclamation Permit and Colorado Statutes, you must submit Annual Fees and Annual <br />Reports. You must pay the Annual Fee and submit an Annual Report each year until reclamation responsibility <br />release is granted. The Annual Fee is not a renewal fee. The fee and the report are for LAST YEARS mining d <br />reclamation season, and MUST be received even if your operation was in an inactive state. The fee and re port are <br />due ON OR BEFORE your permit anniversary date shown below. The Annual Report and Fee nmg and <br />not met until we have received the following components: fee re ort and associated ma . If no new <br />nt is <br />disturbances or recla have occurred durin 4 p• If no <br />the revious ear and no new chan <br />ear's ma <br />• <br />• <br />• <br />is re uired <br />rovided that the 0 <br />erator shall state this in the <br />es to the revious <br />responsibility release from the Division of Reclamation, Mining and Safety (the <br />released by your anniversary date listed below, the annual fee MUST be paid. If <br />anniversary date, then by Statute, you do not pay an annual fe <br />e or submit an <br />PLEASE NOTE: IF THE ANNUAL FEE, ANNUAL REPORT, AND A MAP ARE NOT RECEIVED ON OR <br />BEFORE YOUR ANNIVERSARY DATE, A FORMAL NOTICE OF VIOLATION AND A BOARD ORDE R TO TO <br />PAY CIVIL PENALTIES IN THE AMOUNT EQUAL TO THE ANNUAL FEE $ $323.00 WIL <br />BE <br />AUTOMATICALLY ASSESSED. NO PERMITS FOR NEW MINING OPERATIONS SHALL BE GRAN <br />TO ANY OPERATOR WHO IS CURRENTLY FOUND TO BE IN VIOLATION IN THIS STATE C.R TED <br />32.5 -120 OR C.R.S. 34 -32 -120) UNTIL THE VIOLATION IS ABATED. ( S. 34- <br />Division records indicate $323.00 fee is due <br />M -1989 -023 <br />Caliche School Pit <br />March 9, 2012 <br />$323.00 (Due on or before your Anniversary Date) <br />If your records indicate different facts than those stated above please notify the Division. <br />Please return the enclosed annual report FORM, a MAP, and a CHECK or MONEY ORDER made y a able t <br />Division of Reclamation, Mining and Safety, 1313 Sherman St., Room 215, Denver, Colorado 80203. P to the <br />Thank you for your cooperation in this matter. If you have any questions, please feel free to contact Jim 866 -3567 ext. 8119. m Du pier <br />Office of <br />Active and Inactive Mines <br />