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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />C O L O RA D O <br />Denver, Colorado 80203 <br />D t v l s i o N o f <br />RECLAMATION <br />Phone: (303) 866 -3567 <br />MINING <br />FAX (303) 832 -8106 <br />SAFETY <br />August 1, 2013 <br />John W Hickentooper <br />Govemor <br />Mike King <br />Mario Bassi <br />Executive Director <br />Mario Bassi and Josephine Bassi <br />Loretta E P+neda <br />2000 N. Fatm Rd. <br />Director <br />Monte Vista, CO 81144 <br />North Farm Road Gravel Pit, Permit M- 2000 -110, Annual Fee Invoice and Report Request <br />III FASI: ill t-D L .%..ti'i i Ll -\ \( <br />Please.11lach Nnul ( ()\ipl F-1 FI'> y,riticil \nnu:tl Perinrl and \nnual ltrhort daft ht this form <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 i\-IUST 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 NIAP as required by rule <br />If you have requested reclamation responsibility release from the Division of Reclamation, Mining and Safety <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 5791.00 fee is due for the following: <br />Permit: M- 2000 -1 10 <br />Operation Name: North Farm Road Gravel Pit <br />Anniversary Date: September 17, 2013 <br />Total Fee Due: S791.00 (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 215, Denver, CO 80203. If your records indicate <br />these documents and fees have already been submitted, please notity the Division. <br />If you have additional comments and/or information that should be provided to the Division, please provide it below <br />or attach it to this form along with your alTincn report and map. Annual Report instructions are enclosed. If you <br />have any questions, please feel free to contact Jim Dopler (303)866- 3567 x8119 or Christine Brookshire (303)866- <br />3567 x8132. Thank you for your cooperation in this matter. <br />1 \FIiK(I \;1 \T <br />\li!t> \ti'.i \1 <br />Office of Office of <br />Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines <br />