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J <br />PERMI'ITEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Penn Mountain Minleg, Ine. <br />M-1985-022 <br />Bullger Basin Placer <br />May 23, 2003 <br />RECEIVED <br />MAY 2 22603 <br />OtYldaa ai Minerals and Geology <br />$550.00 (Due on or before your anniversary date) <br />Perk <br />According to C.R.S. 34-32.5-116 or C.RS. 34-32-116, each year, on the anniversary date of the permit, an <br />hallsabtttit-tha-anmral-fee,-azaportand-map-sh rls~teeS'rii`51Ye2~d'-- <br />~ land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />j beginning of active operations, and the date active operations ceased for the year, if any. <br />Pleace Attach your revised written anm.al report and anm.al rennrt mwn,tn Chic form- hlg¢T¢ gate that !N <br />adequately labeled map [hat c%arly delineates and irtc/odes the above elements may since jar a wri[terr <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee t:ontact: John V. Browning <br />Permittee Name: Penn Mountain Mining, Inc. <br />Address: 6182 S. 2855 E. <br />Phone Number. <br />Fax Number. <br />Ogden, UT 84403 <br />(801) 479-3754 <br />(801)479-9410 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Repoli instructions are <br />enclosed. <br />r n 1~ L.~itiylwrvo . <br />Si tore of Corporate Offi r, Owner, or Designee <br />~~i ~, X03 <br />Date <br />M:IPERMITMASTERPOGIIMEMS/M-AF-0I.DOC <br />