2013-05-09_REPORT - M2010084

• Permit No: M2010084
• IBM Index Class Name: REPORT
• Doc Date: 5/9/2013
• Doc Name: ANNUAL FEE/REPORT
• From: OPERATOR
• To: DRMS
• Email Name: THM
• Media Type: D
• Archive: No

STATE OF COLORADO
DIVISION OF RECLAMATION, MINING AND SAFETY
Department of Natural Resources
1313 Sherman St., Room 215
Denver, Colorado 80203
Phone: [phone]
FAX: [phone]
April 1, 2013
Tim Mantle
Lost Cause, LLC
27002 CR 5
Rifle, CO 81650
Lost Cause Pond, Permit M 2010-084, Annual Fee Invoice and Report Request
COLORADO
DIVISION OF
RECLAMATION
MINING
SAFETY
John W. Hk kenlooper
Governor
Mike long
Executive Director
Loretta E. Pineda
Director
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Under the terms of your NOI or Reclamation Permit and Colorado Statutes, you must submit Annual Fees and
Annual Reports (including a map). You must pay the Annual Fee and submit an Annual Report each year until
reclamation responsibility release is granted. The Annual Fee is not a renewal fee. The Fee and Report are for
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:
1. APPROPRIATE ANNUAL FEE
2. COMPLETED ANNUAL REPORT
3. ASSOCIATED MAP as reauired by rule
If you have requested 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 be paid. If
the permit is released before the anniversary date, then by Statute, it is not necessary to pay an Annual Fee or submit
an Annual Report for that year.
Division records indicate the $323.00 fee is due for the following:
Permit:
M- 2010 -084
Operation Name:
Lost Cause Pond
Anniversary Date:
May 6, 2013
Total Fee Due:
$323.00 (Due on or before your Anniversary Date)
Return the enclosed Annual Report FORM a MAP. and a CHECK or MONEY ORDER made payable to: Division
of Reclamation, Mining and Safety, 1313 Sherman St., Room 215, Denver, CO 80203. If your records indicate
these documents and fees have already been submitted, please notify the Division.
If you have additional comments and/or information that should be provided to the Division, please provide it below
or attach it to this form along with your written report and map. Annual Report instructions are enclosed. If you
have any questions, please feel free to contact Jim Dupler (303)866 -3567 x8119 or Christine Brookshire (303)866-
3567 x8132. Thank you for your cooperation in this matter.
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