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• III IIIIIIIIIIIIIIII (K�p 5- <br /> 41 \ %� <br /> ' sss <br /> ANNUAL FEE and REPORT REQUEST RECEIVED <br /> NOV 2 9 2WO <br /> PERMITTEE NAME: Gold Eagle Mining, Inc. <br /> PERMIT NO.: M-1977-297 <br /> OPERATION NAME: Burros Mine <br /> ANNIVERSARY DATE: November 29,2000 <br /> ANNUAL FEE DUE: $225.00 (Due on or before your anniversary date) <br /> COUNTY: San Miguel <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 report and annual report map to this form. Please note that at <br /> adequately labeled map that clearly delineates and includes the above elements may sufj7ce for a written <br /> report. No additions or corrections to information on file. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Don Coram <br /> Permittee Name: Gold Eagle Mining, Inc. <br /> Address: 845 E. Main St. <br /> P.O. Box 3007 <br /> Montrose, CO 81401 <br /> Phone Number: (970) 249-0404 <br /> Fax Number: (970) 240-3292 <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 /> F41v,,A— <br /> Signature Corporate Officer or Owner <br /> na � <br /> Date <br /> M TERM WIMASTERDOCUMEN SIM Ar-02.DOC <br />