2017-03-23_REPORT - M1988112

• Permit No: M1988112
• IBM Index Class Name: REPORT
• Doc Date: 3/23/2017
• Doc Name: Annual Fee/Report/Map
• From: Battle Mountain Resources, Inc.
• To: DRMS
• Annual Report Year: 2017
• Email Name: WHE
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following pennittee/landowner contact information(blank fields indicate that we do not have
information on record). If this information is blank or not current, please type or print current contact infonnation:
Permittee Contact: Lawrence Fiske
Permittee Company: Battle Mountain Resources,Inc.
Address: F.O.Box 310
San Luis,CO 8 1 1 52-03 10
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: William Lyle Lawrence Fiske
Company: Battle Mountain Resources,Inc.
Address: P.O. Box 310
San Luis,CO 8 1 1 52-03 10
Phone Number: [phone]
Fax Number: 719-379-0713
Email Address: [e-mail]
Inspection Contact: Julio F.Madrid
Company: Battle Mountain Resources,Inc.
Address: P.O. Box 310
San Luis,CO 81152-0310
Phone Number: [phone]
179-379-0538
Fax Number: [phone]
Email Address: [e-mail]
I,the undersigned,hereby state that the information provided in this report is true and accurate,and that site operations are
being conducted in accordance with the Division approved mining and reclamation plans.
03/13/2016
Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date
NI-AF-02