2005-09-06_REPORT - M1981185

• Permit No: M1981185
• IBM Index Class Name: Report
• Doc Date: 9/6/2005
• Doc Name: Annual Fee/Report/Map
• From: Shalako International Inc
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Shalako International Inc
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May Day Mine l~~ivtrto ooao~n°F''~/ ~C~
September 5, 2005 /~'
$225.00 (Due on or before your anniversary date)
La Plata
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on [he anniversary date of the permit, an
operator shall~mit the an.,~~al_fee,_a_reperY--and-map-shorting-the~xtent-of-current-distnrb~nees 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 ynnr revised written anmral rel7nrt and annual rennrt m:~n to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: John H. Ferguson
Permittee Name: Shalako International Inc
Address: P.O. Box 2030
Durango, CO 81302
Flr6ac Numberi (970j 249=2279 - -" -- ---
Fax Number; [phone]
If you have additional comments andlor 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.
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Signatu of Corporate O r, Owner, or Designee
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