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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~_ (~P i <br />AL FEE and REPORT REQUEST <br />- Gold Eagle Mining, Inc. <br />~M-1977-248 <br />C-JD-S <br />June 16, 2007 <br /> <br />R~G~~VED <br />~ JAN Y 52007 <br />division of Reclamation, <br />Mining and gate <br />ry <br />$$550.00 (Due on or before your anniversary date) <br />Montrose <br />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 vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous vear and no <br />new changes to the previous year's map are necessary. then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delin~~egqtes and includes the above elements may since for a written report. <br />/.V~ ,~-6~rT~os~s ax /c~t,«riQ~ S F~o~l l'cr~itE.vT /~~~' <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Don Coram <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Gold Eagle Mining, Inc. <br />845 E. Main St. <br />P.O. Box 3007 <br />Montrose, CO 81402 <br />(970) 249-0724 <br />(970) 249-3292 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or a c t this form along with your written report and map. Annual Report instructions are <br />enclosed <br />Si afore of orporate Officer, Owner, or Designee <br />Dat <br />M:~PERMITMASTERDOCUMENTS/M-AF-02.DOC <br />