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/91~ i1 l~ </ ~ V '~' / <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNTiAT. FF.F. and REPORT RR(ITTF.ST <br />Ca ais Resources Colorado, Inc. <br />YI-1977-410 <br />Cross Gold Mine <br />November 3, 2005 <br /> <br />~` ~~' `^~ <br />~Ol! 0 ~ 2005 <br />$225.00 (Due on or before your anniversary date) <br />Boulder <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />- - -land; reclamation-accomplished-to-date-and-during the preceding-year,-new-disturbances-that-are anticipated-to- <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annnal re~nrt and anmial re nn rt m ~n to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the fallowing permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact-. Thomas S. Hendricks <br />Permittee Name: Calais Resources Colorado, Inc. <br />Address: Cross Mine Road <br />P.O. Box 653 -Caribou <br />Nederland, CO 80466-0653 <br />Phone Number: (303) 258-3806 <br />Fax Number: (303) 258-0402 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />belpw or attach it to~his form along with your written report and map. Annual Report instructions are <br />Owner, or Designee <br />Date <br />M:~PEAMIINIASTERDOCUMENT$/M-AP-02.DOC <br />