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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 />July 2, 2012 <br />STATE OF COLORADO <br />f I. <br />C. D <br />COLORADO <br />D I V I S I ON Of <br />RECLAMATION <br />MINING <br />SAFETY <br />John W. Hickentooper <br />Governor <br />Scott Hall ft l' Mike King <br />Black Diamond Minerals, LLC JUL 71 Executive Director <br />1600 Stout Street, Suite 1710 <br />Denver, CO 80202 .7t Loretta E Pineda <br />Director <br />Tepee Park Ranch Shale Borrow Pit, Permit NI- 2008 -027, Annual Fee Invoice and Report Request <br />PLEASE READ CAREFULLY — ACTION REQUIRED <br />Please attach vour COMPLETED written Annual Report and Annual Report Map to this farm <br />Under the terms of your NOI or Reclamation Permit and Colorado Statutes, you must submit Annual Fees and <br />Annual Reports (including a map). You must pay the Annual Fee and submit an Annual Report each year until <br />reclamation responsibility release is granted. The Annual Fee is not a renewal fee. The Fee and Report are 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 the following <br />components: <br />1. APPROPRIATE ANNUAL FEE <br />2. COMPLETED ANNUAL REPORT <br />3. ASSOCIATED it1AP as required by rule <br />If you have requested reclamation responsibility release from the Division of Reclamation. Mining and Safety (the <br />"Division ") but your permit is not released by the anniversary date listed below, the Annual Fee MUST be paid. If <br />the permit is released before the anniversary date. then by Statute. it is not necessary to pay an Annual Fee 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- 2008 -027 <br />Operation Name: Tepee Park Ranch Shale Borrow Pit <br />Anniversary Date: Au- gust 5, 2012 <br />Total Fee Due: $323.00 (Due on or before your Anniversary Date) <br />Return the enclosed Annual Report FORM. a MAP. and a CHECK or MONEY ORDER made payable to: Division <br />of Reclamation. Mining and Safety. 1313 Sherman St., Room 21.5, Denver, CO 80203. If your records indicate <br />these documents and fees have already been submitted, please notify the Division. <br />If you have additional comments and/or information that should be prop ided to the Division, please provide it below <br />or attach it to this form along with your written report and map. Annual Report instructions are enclosed. If you <br />have any questions, please feel free to contact Jim Dupler (303)866 -3567 x8132 or Christine Brookshire (303)866- <br />3567 x8132. Thank you for your cooperation in this matter. <br />IF THE ANNUAL FEE SUBMITTALS ARE NOT RECEIVED ON OR BEFORE YOUR ANNIVERSARY <br />DATE, THE ENFORCEMENT PROCESS WILL BE AUTOMATICALLY INIATIED. ENFORCAIENT <br />ACTIONS MAY RESULT IN CIVIL PENALTIES AND /OR REVOCATION OF YOUR PERMIT. <br />Office of Office of <br />Mined Land Reclamation Denver - Grand Junction • Durango Active and Inactive Mines <br />