2013-12-02_REPORT - P2010003

• Permit No: P2010003
• IBM Index Class Name: Report
• Doc Date: 12/2/2013
• Doc Name: Annual Fee and Report Invoicing January 2014
• From: DRMS
• To: Operator
• 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]
John W. Hickenlooper
Governor

Mike King
Executive Director

Loretta E. Pineda
Director

Under the terms of your NOI 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 exploration 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. ANNUAL FEE ($86)
2. COMPLETED ANNUAL REPORT
3. ASSOCIATED MAP as required 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 $86.00 fee is due for the following NOI(s) on or before the Anniversary Date:

Permit: P-2010-003
Operation Name: Greyhound Mine Exploration
Anniversary Date: January 18, 2014

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 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 Michelle
Ramirez [phone] x8114. Thank you for your cooperation in this matter.

IF THE COMPLETE ANNUAL FEE SUBMITTALS ARE NOT RECEIVED ON OR BEFORE YOUR ANNIVERSARY DATE,
THE ENFORCEMENT PROCESS WILL AUTOMATICALLY BE INIATIED. ENFORCEMENT ACTIONS WILL RESULT IN
CIVIL PENALTIES AND POSSIBLE REVOCATION OF YOUR PERMIT. PER RULE 5.6(2) FAILURE TO SUBMIT AN
ANNUAL REPORT FOR TWO CONSECUTIVE YEARS SHALL CONTITUTE EVIDENCE OF ABANDONMENT OF
PROSPECTING.

Jack Clark
Jack Clark, Jr.
P. O. Box 767
Silverton, CO 81433
December 2, 2013
Greyhound Mine Exploration, Permit P-2010-003, Annual Fee Invoice and Report Request

PLEASE READ CAREFULLY – ACTION REQUIRED
Please attach your COMPLETED written Annual Report and Annual Report Map to this form
Office of Office of
Mined Land Reclamation Denver • Grand Junction • Durango Active and Inactive Mines