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.ANNUAL FEE and REPORT REQUEST <br />PERMITTEENAME: Rocky WestMioiogCorp. RECCIVE~ <br />PERMIT NO.: M-1982-058 MAY 0 8 1001 <br />OPERATION NAME: Poorman Mine Division of Minerals and Geology <br />ANNIVERSARY DATE: June 14, 2001 <br />ANNUAL FEE DUE: $225.00 (Due on or before your anniversary date) <br />COUNTY: Clear Creek <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 lee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding ycar, new disturbances that arc 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 resort and annual report map to this form. Please note [hot an <br />adequately labeled Wrap that clearly delit:eates and includes the above elemen[s Wray since for a written <br />repor[. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Alvin Mosch <br />Permittee Name: Rocky West l~lining Corp. <br />Address: Box 3236 <br />Idaho Springs, CO 80452 <br />Phone Number: (303) 567-4565 <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 are <br />enclosed. <br />,. <br />Signature of Corporate Officer or Owner <br />-~-ol <br />Date <br />M:~PERMIT~AIHSTERDOC U MENTS/M-AF-02.DOC' <br />