2007-05-21_REVISION - M1997032

• Permit No: M1997032
• IBM Index Class Name: Revision
• Doc Date: 5/21/2007
• Doc Name: Transfer of Permit and Succession of Operators Application Form
• From: Denison Mines ‎(USA)‎ Corp.
• To: DRMS
• Type & Sequence: SO1
• Media Type: D
• Archive: No

_
ft. AllMINISTRATTVE L~'FORMATTON:
1. Permit Number:
2. Operation Name:
3. Current Permitted Operator:
Contact Person:
Company Name;
Street:
City;
State:
Area Code:
4. Successor Operator:
Contact Person:
Company Name:
Street:
City:
State:
Area Code:
[RS Tax ID No. or Social Security No.:
M-1997-032
Van 4 Mine
Terry Wetz
International Uranium (USA) Corp.
105017th Street, Suite 950
Denver
Colorado 80265
Zip Code:
(303) Telephone: [phone]
Christy Woodward
Denison Mines (USA) Corp.
95017`' Street, Suite 950
Denver
Colorado 80265
'Lip Code:
(303) 'Celephone: 628-7798

5. Application Fee: $100.00 For Hard Rock operations; $125.00 for Construction Materials operations
Make check payable to the Division of Reclamation, Mining and Safety