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<br />A,N~N'TIAT. FF,F, and RF.POI <br />PERMITTEE NAME: ~ Gold Eagle Mining, Inc <br />PERMIT NO.: ~1GI-1977-297 RECE! VED <br />OPERATION NAME: Burros Mine ,l <br />"' <br /> <br />ANNNERSARY DATE: V 2 9 <br />~~~~ <br />November 29, 2005 ~ <br />ANNUAL FEE DUE: $225.00 (Due on or before your anniversaP~'89R@~Minerals and Geology <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 />.i <br />eperato=sha;, -.-thy-ara-,ua]-fee; a-reporhand-map-showing-the-extent-of-currentziisturbartces`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 anm,al report mai to Chic form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />U /dl~O/7/b ~S QiC. l'it' ~£cl (set S /~i~o ~n r''a/t~F.~T /'/~~~ <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 />~~ <br />Signature of Co orate Officer, O er, or Designee <br />~~r~~ <br />Date ~ <br />M:~PEAMIIIMASTERDOCUMENTS~AI-AF-02.DOC <br />