2003-12-15_REPORT - M1983052

• Permit No: M1983052
• IBM Index Class Name: Report
• Doc Date: 12/15/2003
• Doc Name: Annual Fee/Report Notice
• From: Mining and Minerals Ltd.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
R~~~6~f~t;1
DEC 9 ,~ 2003
PERMTITEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Mining and Minerals, Ltd.
M-1983-052
Joker Mine
September 1, .20a ~
ttivision of Minerals antl Geology
$550.00 (Due on or before your anniversary date)
Moffat
According to C.R.S. 3432.5-116 or C.R.S. 3432-116, each year, on the anniversary date of the permit, an
-----operatarsitall-submit-the-annual-fees a-report-and-map showing-the-exten~of currentdisturbancesloaffected_- -
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 during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual retwrt and annual report map to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may st~ce for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Barbara R. Chalrrrers
Permittee Name: Mining and Minerals, Ltd.
Address: 8115 Preston Rd #680
Dallas, TX 75225
Phone Nnmtiec`---(214) b91=2032- -- `- -- "
Fax Number: [phone]
If you have additional comments andJor 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
9-03
Dale