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RECEIVED <br />ANNUAL FEE and REPORT REQUEST APR 3 0 2002 <br />vision of Minerals and Geology <br />PERMITTEE NAME: Indian Springs Mining <br />PERMIT NO.: M-1981-020 <br />OPERATION NAME: Thorsen Mine <br />ANNIVERSARY DATE: May 6, 2002 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an operator <br />__ __ shall submit the_annual fee^ a-report and_m_ap_showing the extent of current disturbances to_affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming yeaz, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pemtittee Contact: Cazlina Henry <br />Permittee Name: Indian Springs Mining <br />Address: 3257 CR 67 <br />Penrose, CO 81240 <br />Phone Number: (719) 372-3907 <br />Fax Number: <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 aze enclosed. <br />Signature of Corporate Officer or Owt r <br />gl ~ 7-oa- <br />Date <br />M iPERMITUTASTERDOCUMENTSVN-AF-01 <br />