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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br /> <br />ANNUAL FEE ar[d REPORT REQUEST <br />Calais Resources Colorado, loc. <br />M-1977.410 <br />Cross Gold Mine <br />November 3, 2000 <br />$225.00 (Due on or before your anniversary date) <br />Boulder <br />According to C.R.S- 34-32..5-11F or C.R.C. 34-32-11(i, each year'. on the anniversary date of the permit, an <br />- opcratocshall subnut.the.annaal fec, a report and map-spewing-rite ex[ent of curreu[ disturbances.to affected --- <br />land, reclamation accomplished to date and during the preceding year, new disturbances tha¢ are anticipated to <br />occur during [he upcoming year, reclamation that will be ptrformtd during tht coming yea:-, the dales for the <br />beginning of active operations, attd the daft activt operations ctastd (or the year, if any. <br />Please attach vour revised written annual report and annual rcuort map w this form. Please rote that an <br />adequattly labeled mop that clearly deltneares aril iirclu~es rite above clemcnh~ may su~fce for u written <br />report. - R I I AGt~t:d~ -' <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Ptrmitttt Contact: Thoma. S. Hendricks <br />Permittee Na[ttt: Calais Resoure~s Culorado, Inc. <br />Address: Cross Mine Road <br />P.O. Box 653 - Caribuu <br />Nederland, CO 80466 <br />Phune Number: (303) 258-3806 <br />Fax Number: •'~3-7.S6-t7~OZ <br />If you have additional cotrtments and/or information that should be providtd to the Division, please provide it <br />below or attach it [o this form along with your written report and map. Annual Report ins[ruc[ions are <br />Signatttre of Cc <br />Date <br /> <br />M:V'L'IfMInMAti I'IiRD(x:tIMP.M5MI-AF-02,DOC <br />Officer or Owner <br />£d Wdbb:b0 0002 L0 '~a0 Z0b0 SSZ £0£ 'ON 3NOHd S~I~I2iQN3H Slti~tiJ W021d <br />