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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />International Uranium (USA) Corp. <br />M-1997-032 <br />Van 4 Shaft <br />November 3, 2003 <br /> <br />OCT 2 ~ 2003 <br />Ilivisian of Minerals and Geola^•' <br />$225.00 (Due on or before your anniversary date) <br />Montrose <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />operator-shall-submit-the-armual-fee~-report-anfimap-showing-the-extent-of-current-disturbances-to-affected- ---- <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to I <br />occur during the upcoming year, reclamation that will be performed during [he coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual rennrt and annual rennrl man to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Terry V. Wetz <br />Permittee Name: International Uranium (USA) Corp. <br />Address: 1050 Seventeenth St., Ste. 950 <br />Denver, CO 80265 <br />---- -Phone-Number-(303)628-7798 - <br />Fax Number: (303) 389-4125 <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 Report instructions are <br />enclosed. <br />bf Corporate Officer, Owner~+ or Designee <br />e. f.Xdc.du.d r V; ce rretrIX4c{ d Cre~e.n,( Cow.s•~ <br />Date <br />M:\PERM nU1 ASTERDOCUM ENTS/M-AF-02. DOC <br />