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COLORADO <br />D I V I S I O N O F <br />RECLAMATION <br />MINING <br />— &— <br />SAFkTY <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St,, Room 215 <br />Denver, Colorado 80203 <br />Phone (303) 886 - 3567 <br />FAX: (303) 832 -8106 <br />December 3, 2012 <br />Shane Cooper <br />Shane Cooper <br />949 Shannon Rd. <br />Cotopaxi, CO 81223 <br />1. APPROPRIATE ANNUAL FEE <br />2. COMPLETED ANNUAL REPORT <br />3. ASSOCIATED MAP as required by rule <br />Office of <br />Mined Land Reclamation Denver - Grand Junction • Durango <br />STATE OF COL I RADO <br />John W. Hickenloopar <br />Governor <br />Mike King <br />Executive Director <br />, Loretta E Pineda <br />Director <br />Iron Mountain Road Gravel Pit, Permit M- 1994-092, Amlival Fee Invoice and Report Rashest <br />PLEASE READ CAREFULLY — ACTION REQUIRED <br />Please attach your COMPLETED written Annual Report and Annual Report Map to tills form <br />Under the terms of your NOT or Reclamation Permit and Colorado Statutes, you must submit Annual F s and <br />Annual Reports (including a map). You must pay the Annual Fee and subunit an Annual Report each y until <br />reclamation responsibility release is granted. 1111e Annual tee is not a renewal fee_ "l he Fee and Report re for <br />LAST YEAR'S (mining and reclamation season, and MUST be paid even if your operation was inactive: <br />The Annual Report and Fee requirement will be considered submitted when we have received thel ollowing <br />components; <br />66 <br />If you have requested reclamation responsibility release from the Division of Reclamation, Mining and i;afety (the <br />"Division ") but your permit is not released by the anniversary date listed below, the Annual Fee MUS i e paid. If <br />the permit is released before the anniversary date, then by Statute, it is not necessary to pay an Annual a or submit <br />an Annual Report for that year. <br />Division records indicate the $323.00 fee is due for the following: <br />Permit: M- 1994 -092 <br />Operation Name: Iron Mountain Road Gravel Pit <br />Anniversary Date: January 23, 2013 <br />Total Fee Due: $323.00 (Due on or before your Anniversary Date) <br />Return the enclosed Annual Report FORM, a MAB and a CHECK or MONEY ORDER made payablej o: Division <br />of Reclamation, Mining and Safety, 1313 Sherman St., Room 215, Denver, CO 80203. If your records j dtcate <br />these documents and fats have already been submitted, please notify the Division. <br />If you have additional comments and/or information that should be provided to the Division, please pr ide it below <br />or attach it to this form along with your written repoitt and map. Annual Report instructions are enclos . If you <br />have any questions, please feel free to contact Jim Duplex (303)866 -3567 x8119 or Christine Brookshire 03)866- <br />3567 x8132. Thank you for your cooperation in this matter. <br />IF TIC ANNUAL tht, SUBMITTALS ARE NOT RECEIVED ON OR BEFORE YOUR ANNIVERSARY <br />DATE, THE ENFORCEMENT PROCESS WILL BE AUTOMATICALLY INIAT IED. ENFORC <br />ACTIONS MAY RESULT IN CIVIL PENALTIES AND /OR REVOCATION OF YOUR PERMIT. <br />Office of <br />jikctive and Inactive Mines <br />