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li ANNiiAi. FFF. and RF.PnRT RRl1iiRST PERMITTEE NAME: ~ Rocky West Mining Corp. ~ ~ py~8c(~iitl ~*' D-~'Gt~f ' PERMIT NO.: M-1982-058 / OPERATION NAME: Poorman Mine RECEPVED ANNIVERSARY DATE: June 14, 2003 MAY r g p003 ANNUAL FEE DUE: $225.00 (Due on or before your anniversary d~ion of Minerals and Oepto9Y COUNTY: Clear Creek 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 __ operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected 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 attachn~r revised written annual re,pnrt and anneal re~prt mar to this form. Please note that an adequately labeled map that clearly delineates and includes the above elements may since for p written report. Division records indicate the following permittee contact information. Please verify and make any necessary '~ changes: ~- wt ~ / 9 S a -6 .S" g. ?. Permittee Contapt: Alvin Mosch N o e' l-~ A ..C 4. ~.y / L t„~. i -s.,.. . _ ~. P~rmittee Name: Rocky West Mining Corp. ~ ,1' r~ s 'Address: Box 3236 (q e i r ~ e ?' ~ - ~ !9 ..rr „o c J4 ~ i9 e Idaho Springs, CO 80452 Ste. atc P/ ~ U ~' ',. ~ ~7 e kL w . T- rrr , 19' 8 2~- , v 7 -s --~--Phone-Number:-(343}567-4565- - Fax Number: If you have additional comments and/or 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. t.-a-/ 1 Signature of Corporate Officer, Owner, or Designee Date - /7-c M:IPERMIr1MAS7ERDOCtJMEMS/M-AF-02. DOC