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/~ F ~ ~PPi <br />ANNiIAi, FF.F, and RF,PtiRT RF, c i(,~.ST <br />PERMITTEE NAME: M~o nt Royale Ventures, LLC / ' <br />PERMIT NO.: //M-1983-141 U <br />OPERATION NAME: Cash & Who Do Mines ~~j " ~ G~iQS <br />ANNNERSARY DATE: September 7, 2005 / ~~1°~S~an of f.~,i„~~_~_ , ~-o;c , <br />ANNUAL FEE DUE: $225.00 (Due on or before your anniversary date) <br />COUNTY: Boulder <br /> <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 annual re~nrt and anm~al report main 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: Matt Collins <br />Permittee Name: Mount Royale Ventures, LLC <br />Address: 9145 Sunshine Canyon Dr. <br />Boulder. CO 80302 <br />,Phone~himber• (303).SZO-6269. - - - <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 />~i%/ - <br />Signa a of Corporate Officer, Owner, or Designee <br />~/~~/~- <br />Dat <br />MiPERMINIASTERDOCUMENTS/M-A£-02.DOC <br />