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<br /> <br /> <br />STATE of COLOR <br />u mStON OF mcumA710N, AUNSNG AND SAFEff <br />Drepartenc a of Natrsal Itmewces <br />Nnvamca, LLC <br />10771-3200 Rd <br />HotcWdss, CO 81419 <br />1313 Sherman SL, Room 215 <br />Owner, Cuwrmb 50203 <br />pharem Owl 866.3567 <br />IUC10DCr I,1008 Ye <br /> ORADO <br /> F <br /> F <br />DIVIS10i 1 u, ;? eclamai,on A <br />, <br />Kning and Safety <br />Ell ? <br />Jr <br /> . <br />. <br />NinK 0. Slneleta? <br />LAW RING A>L?IAIW W y R saliva olac or <br />il0(21 AN1?Q? FETs Il+IYdICE ARID R1?RT RFAUEST r+W.&W. C my <br />-- Dircaon tlirex?or <br />*4m. w x0muFm if mm <br />PLEASE K JP CAREFULLY <br />Under &a urms of yow R?dclammion Peram and Colorado Statutes, you man m du= Annual Fees a=d Annual <br />Reports. You must pay the Amlual Fee and submit an Annual Report each yeas unfit rech m flan ee?asi bilzr' y <br />release is gcammd. The Animal Fro is am a zcwwal fee. The fee and the report m for j A"1!' YEARS miring <br />SSW Te 11 -, a *won, amd MUS be r cam d evm if your operationsvvw m w ine c6v smw- The fee and <br />report we d he OW OR BEFORE y= p?t annimmy date shown below. The Annual Report and Few <br />regairemet in ms met until we have reed d the foO m ft coaapoaeldc f and awadsad Imam <br />Nno mw jjjft!jftfiM or ?_maibn ?e oeca Mid darioe the prayielm ?r? am new ? m the <br />- --- --- ------- -: d_ -- d9---- Lin __ <br />If you hnvC ? m jesponslb ft Telem from the Division of Rw1autamoa. Mmmg and Safety <br />be <br />(tire -DWisi m') but your permit is not released by yow ? dame hgmd below, the annual fee M 1151 <br />paid. If Sep"n it is mckased before *C dater *cn by Statute, yoat do nos pay an uannal fee ar <br />submit an aTmaal meet four tic 34m- <br />nf:&f ffi 1?-CM! IF IM ANWAL ffM. ANNUAL REPORT, AND A MAP ARE NOT RECE VED ON OR <br />1tDER <br />YOM ANNIVERSARY DATE, A FORMAL NOTICE OF V10LAMN AND A BOARD 0 <br />To p-" C pjMjjM W TSB AMOUNT EQUAL TO THE ANNUAL FEE SS259.00 WILL. BE <br />SESSSFA. NO PFRA+IITS ]FOR. NEW bffM 1G OPERATIONS SHALL BE GRANTED <br />TO ANY OPERATOR wH0 LS CURRENTLY FOUM TO BE 1N v101ATION IN THIS STATE MRS. 34- <br />325-120 OR GR.S. 34-32.120) UNI7L. THE VIOLATION IS ABATED. <br />Division records indicate S M.00 fee is due <br />PermiENo.: bi-1977--293 L// <br />Opmmtbm Name: moswg?ram-la Dandy <br />Aumversmy Dale: November 27, 2009 <br />Total Fee Dam $25900 (Due on or before your Annrversmy Date) <br />If your =cot& indmme &ffemn facts than lhase steixed abam please notify ttm Dmslott't . <br />Please rtima the enclosed annual report a M6h and a ..or M-0= B made payable to <br />title Nvisi m of Ramon, mudug and Safety, 1313 Simmutz St., Room 315, Deaver, Colorado 80203. <br />mm* you for your aooperatioa in this matws if yon helve any questions, Please feel five to control May <br />RDdrTtaex at (303) S"42074. <br />014ce of <br />(r?WA lu d kdi wdm Dw w r GrMd luno6an ? DbMIP Acting acrd inucli a Mines <br />S 1 4 N O 1 <br />AMATiON <br />TNING <br />f?ETY <br />7-Ci QCl] f)-CC`Q-CM` NA01P4 MIZI CIG47171. Pn on AON