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T~. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNTTAT, FF.F, and RF,PORT RF,OTiF.Ii~~®h <br />ti <br />Gold Eagle Mining, Inc. ~~~ ~~ ~Q~ <br />M-1978-342 <br />Ellison Mine <br />February 15,2005 <br />RECEIVED <br />MAR 0 4 20J5 <br />Oirision itf Minerals and Geology <br />$225.00 (Due on or before your anniversary date) <br />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 />__.occtlr_dLLC1nQ_th . ,_ . sncnming~gar~clamation that will be nerformed 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 y~nnr revised written anm~al report and anmial rennrt maT to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <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) 249-3292 <br />~' u ,PrCeu % ~f7°'~~ <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 />N <br />Signature of Corporate Officer, er, or Designee <br />3- ©~ <br />Date <br />M:IPERMITMASTERDOCUMENTS/M-AF-02.DOC <br />