REP35063

• Permit No: M1977297
• IBM Index Class Name: Report
• Doc Date: 11/29/2004
• Doc Name: Annual Report and Fee
• From: Gold Eagle Mining Inc.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Gold Eagle Mining, Inc.
M-1977-297
Burros Mine
November 29, 2004
$225.00 (Due on or before your anniversary date)
San Miguel
!`C~~~ 2 ~ 2C0!a
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
operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected
land. reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming-year, reclamation that will be performed urtng tthe coming year,"the dates foT-ffie
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written anneal re,Pnrt and anneal rennrt main to this form- Please note that an
adequately 1 beled map that clearly delineates and includes t/he above elements may siyn~,c~e,~for a written
report. ~ /~~T/a/Ty GiC l~fi¢~/d2~ S /`~lO~ !'G/C~CC•v7' ~" "' /-
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Don Coram
Permittee Name: Gold Eagle Mining, Inc.
Address: 845 E. Main St.
P. O. Box 3007
Montrose, CO 81401
Phone Number: [phone] %70 . /rYG - ~ s!o?
_Eax Nttmber: _ - [phone] _ 9 7U - ~ T 9- ~ 7 3 f!
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed.
Signature of Corporate Officer, Owner, or Designee
/~~j/dam
Date ~
M:~PERMIPMASTERDOCUMEMS/M-AF-02.DOC