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b tvi ~ <br />(/ ANNIiAI, FF.F, and REPORT RF.t7iiFST <br />PERMITTEE NAME: ~/ Penn Mountain Mining, Inc. ~~4~~9 V L~ <br />PERMIT NO.: // M-1985-022 t~~R 2 4 ~ <br />OPERATION NAME: Bullger Basin Placer <br />~~a ut Ylinerala end GeoloB1 <br />ANNNERSARY DATE: May 23, 2006 <br />ANNUAL FEE DUE: $550.00 (Due on or before your anniversary date) <br />COUNTY: Park <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 thal~r_e_anticipated_to~- <br />-- occur during the upcoming year, reclamation that will be performed during [he 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 fir revised written anmral report and annual report map 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 following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: John V. Browning <br />Permittee Name: Penn Mountain Mining, Inc. <br />Address: 6182 S. 2855 E. <br />Ogden, UT 84403 <br />-Phone Number: (801) 479-3754 _ _ <br />Fax Number: (801) 479-9410 <br />If you have additional comments and/or information that 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 />~ . 1v~ .~ <br />Si ' ture o Corporate Officer, Owner, or Desi~ gne~ <br />y l ~9 /o L. <br />Date <br />M:~PERMITUTASTERDOCUMENTS/M-AF-02.DOC <br />