REP05757

• Permit No: M1991054
• IBM Index Class Name: Report
• Doc Date: 4/1/2002
• Doc Name: Returned Annual Fee Notice
• From: DMG
• To: Indian Creek Mining Corp.
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Indian Creek Mining Corp.
M-1991-054
Proffitt
May 29, 2002
$75.00 (Due on or before your anniversary date)
Saguache
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
-- -operator-shall-submit the-annual-fee, a'reporCand map showing the-exferit-of curre'nt8is~uibances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual resort maa to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written
report.
Division records indicate [he following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Don Flickinger
Permittee Name: Indian Creek Mining Corp.
Address: P.O. Box 342
Saguache,CO 81]49
Phone Number: [phone]
Fax Number:
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed,
Signature of Corporate Officer or Owner
Date
M:IPERMI"rIMASTERDOCUMENTS/M-AF-02. DOC