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cK999 <br /> • 6s\ III IIIIIIIIIIIIIIII <br /> ANNUAL FEE and REPORT REOUEST <br /> PERMITTEE NAME: Calais Resources Colorado, Inc. RECEIVED <br /> PERMIT NO.: t. DEC 1 12000 <br /> OPERATION NAME: Cross Gold Mine <br /> ANNIVERSARY DATE: November 3, 2000 Division o?'Minerals and Geology <br /> ANNUAL FEE DUE: $225.00(Due on or before your anniversary date) <br /> COUNTY: Boulder <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 may to this form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements tttay suffice for a written <br /> report. _ _ <br /> �}I I AcN-ED <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Thomas S. Hendricks <br /> Permittee Name: Calais Resources Colorado, Inc. <br /> Address: Cross Mine Road <br /> P.O. Box 653 - Caribou <br /> Nederland,CO 80466 <br /> Phone Number: (303) 258-3806 <br /> Fax Number: -;�03-2SB -0g0Z <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 /> e losed. <br /> S - <br /> Signature of Corpor e Officer or Owner <br /> 8 00 <br /> Date <br /> M\PERMr\MASTERDOCUMENTSIM-AF-02.DOC <br />