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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Leadville Mining & Milling Corp. <br />M-1990-057 <br />Hopemore Shaft <br />June 18, 2002 <br />$225.00 (Due on or before your anniversary date) <br />Lake <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 />-operatorshall-submit-the annual-fee,- areport-and-map showing-the-extenbof current-disturbancesto-affected-- <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation [hat will be performed during the coming yeaz, the dates for the <br />beginning of active operations, and the date active operations ceased for the yeaz, if any. <br />Please attach vour revised written annual report and annual report map to this form. Please Wore that an <br />adequately labeled map that clearly delineates and includes the above elements may su/,jlce for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pennittee Contact: J. Scott Hazlitt <br />Permittee Name: Leadville Mining & Milling Corp. <br />Address: 316 E. 6th St. <br />Leadville, CO 80461 <br />Phone Number: (719) 486-3000 <br />Fax Number: (303) 486-3000 <br />If you have additional comments and/or information [hat 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 />Signature of Corporate Officer or Owner <br />Dale <br />M:~PERMIThIASTERDOCUMEMS/M-AF-02.DOC <br />