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~/ <br />ANNU FIFE an REPORT REQUEST <br />PERMITTEE NAME: /Urralburu Mining Company <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~VI-1977-501-UG <br />Murietta Mine <br />February 15, 2008 <br />~~ <br />SEE ~ 6 2008 <br />®i ~ ion or ieciamation, <br />Mining and Safety <br />$$259.00 (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 t~ equal fee, a report and-maps owing the extent of current disturbances to atf`ected - - <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 reuort man to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous year's map are necessary, then no new man is reauired, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Benedicto Urralburu <br />G~1~zQSz.c~ /3 hod 7 <br />Permittee Name: Urralburu Mining Company <br />Address: 205 N Willerup Ave <br />DD <br />Montrose, CO 81401 <br />Phone Number: (970) 249-5208 <br />Fax Number: <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 />~J`2 Lif L-t~~ <br />Signature of Corporate Officer, Owner, or Designee <br />~-i- a~o~ <br />Date <br />M:~PERMITIMASTERDOCUMENTS/M-AF-02.DOC <br />