2012-07-05_REPORT - M1986074

• Permit No: M1986074
• IBM Index Class Name: REPORT
• Doc Date: 7/5/2012
• Doc Name: ANNUAL FEE/REPORT
• From: KYM SCHURE
• To: DRMS
• Email Name: BMK
• Media Type: D
• Archive: No

May 1, 2012
Mined Land Reclamation
COY
• _ L V4S ON OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
1313 Sherman St , Room 215
Denver, Colorado 80203
Phone [phone]
FAX. [phone]
Kym A. Schure
Kym A. Schure
12826 CR 37
Sterling, CO 8075 l
Division records indicate
Perrot•
Operation Name:
Anniversary Date:
Total Fee Due
1. APPROPRIATE ANNUAL FEE
2. ('ONIPLETED ANNUAL REPORT
3. ASSOCIATED MAP as required by rule
STATE OF COLORADO
the $323.00 fee is due for the following:
M -1986 -074
Dollei schell Pit
June 30, 2012
$323.00 (Due on or before your Anniversary Date)
RECEIVED
JUL 0 5 2012
Division of Reclamation,
Mining & Safety
Dollerschell I'it, Permit M- 19236 -074, Annual Fee Invoice and Report Request
IF THE ANNUAL FEE SUBMIT IALS ARE NOT RECEIVED ON OR BEFORE YOUR ANNIVERSARY
DATE, THE ENFORCEMENT PROCESS WILL AUTOMATICALLY BE IN1ATIED. ENFORCEMENT
ACTIONS MAY RESULT IN CIVIL PENALTIES AND /OR REVOCATION OF YOUR PERMIT.
COLORADO
o 1 V l S l O n U E
RECLAMATION
MINING
— &—
SAFETY
John W Hickenlooper
Governor
Mike King
Executive Director
Loretta E Pineda
Direcloi
PLEASE READ CAREFULLY – ACTION REQUIRED
Please attach your COMPLETED written Annual Report and Annual Report Map to this form
Under the terns of your NOI or Reclamation Permit and Colorado Statutes, you must submit Annual Fees and
Annual Reports (tncluding a neap). You must pay the Annual Fee and submit an Annual Report each year until
1eclanuwon responsibility release is granted. The Annual Fee is not a renewal fee. The Fec and Report ate l
LAST YEAR'S mining and reclamation season, and MUST be paid even if your operation was inactive.
The Annual Report and Fee requirement will be considered submitted when we have received the following
components:
Il you have iequested reclamation responsibility release from the Division of Reclamation, Mining and Safety
( "Division ") but your permit is not released by the anniversary date listed below, the Annual Fee MUST he paid. If
the permit is released before the anniversary date, then by Statute, it is not necessary to pay an Annual Fee 01 submit
an Annual Report for that year.
Return the enclosed Annual Report FORM, a MAP, and a CHECK or MONEY ORDER made payable to: DIN ision
of Reclamation, Mining and Safety, 1313 Sherman SL, Room 215, Denver, CO 80203. If your records indicate
these documents and fees have already been submitted, please notify the Division.
It you have additional con and /or information that should he provided to the Division, please provide tt below
or attach a to this form along. with your written report and map. Annual Report instructions are enclosed 1f you
have any questions, please feel free to contact Jun Dupler (303)866 -3567 x8132 or Christine Brookshire (303)806-
3567 x8132. Thank you tor your cooperation in this matter.
Office of Office of
Denver • Grand Junction • Durango Active and Inactive Mines