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~ III IIIIIIIIIIIII III ~ <br />ANNUAL FEE and REPORT REQUEST {deceived <br />~,,. ,~;~ <br />PERMITTEE NAME: Shalako International Inc - ,;,9 J;.~ ~GP (~ ;, 2001 <br />PERMIT NO.: M-1981-185 $~~ ~ ~' <br />~"~a ~ ~~ 2®~ p~~ngo Feld Otlice <br />OPERATION NAME: May Day Mine `Ow . <br />""' r plv~lon Of Minerals 8 Geology <br />ANNNERSARY DATE: September 5, 2001 c,~e~~ <br />U~ 1 <br />ANNUAL FEE DUE: $225.00 (Due on or before your anniversary date) :_` ., .:. <br />~o. ,~ <br />COUNTY: La Plata '' '` '`- <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 vour revised written annual report and annual report map to this form. Please mote drat mr <br />adequately labeled map that clearly delinentes and includes the above elements may since for a reritten <br />report. <br />Division records indicate the following permit[ee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: John H. Ferguson <br />Permittee Name: Shalako International Inc <br />Address: P.O. Box 2030 <br />Durango, CO 81302 <br />Phone Number: (970) 247-3448 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide i[ <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of Corporate Of c r or Owner <br />1~~~ <br />Date <br />M 1PERM rM1ASTERD000AI ENrS/A1-AF-0?.DOC <br />