2017-08-11_REPORT - M1977248

• Permit No: M1977248
• IBM Index Class Name: REPORT
• Doc Date: 8/11/2017
• Doc Name: Annual Fee/Report/Map
• From: Gold Eagle Mining
• To: DRMS
• Annual Report Year: 2016
• Email Name: DMC
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permittee/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 information:
Permittee Contact: Don Coram
Permittee Company: Gold Eagle Mining,Inc.
Address: P.O.Box 3007
Montrose, CO 81402
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Don Coram
Company: Gold Eagle Mining,Inc.
Address: P.O. Box 3007
Montrose,CO 81402
Phone Number: [phone]
Fax Number: [phone]
Email Address:
Inspection Contact: Don Coram
Company: Gold Eagle Mining, Inc.
Address: P.O. Box 3007
Montrose, CO 81402
Phone Number: [phone]
Fax Number: [phone]
Email Address:
I,the undersiAnc
te that the information provided in this report is true and accurate,and that site operations are
being condue with the Division approved mining and reclamation plans.
�/Z/A�/7
Signature ooporate Officer,Owner,or Documented Designee Date
M-AF-02