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ANNUAL FEE and REPORT REOUEST <br /> PERMITTEE NAME: Grand Mesa Mining Corp. <br /> PERMIT NO.: M-1977438 <br /> OPERATION NAME: Pickett Corral Mine <br /> ANNIVERSARY DATE: November 1, 2000 <br /> ANNUAL FEE DUE: $225.00(Due on or before December 31,2001) <br /> COUNTY: Montrose <br /> According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date or.'the permit, an <br /> operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br /> reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br /> during the upcoming year, reclamation that will be performed during the coming year, the dates far the beginning <br /> 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 may suffice for a written report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Raymond Fitzgerald <br /> Pennittee Name: Grand Mesa Mining Corp. <br /> Address: C/O Butler, Fitzgerald and Potter <br /> 1155 Avenue of the Americas, 28th Floor <br /> New York, NY 10036 <br /> Phone Number: 212-704-3400 <br /> Fax Number: 212-302-4988 <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 enclosed. <br /> Signature of Corporate Officer or Owner <br /> Date <br />