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~^ ,2~ i <br />ANNUAL FEE and REPORT REQUEST <br />PERMTTTEE NAME: ~G Id Eagle Mining, Inc. ~~('.~~~/~~ <br />PERMIT NO.: ° M-1978-342 ~ 9 boa <br />FEB 2 <br />OPERATION NAME: Ellison Mine Division of Reclamation, <br />~/ Mining and Safety <br />ANNIVERSARY DATE: February 15, 2008 <br />ANNUAL FEE DUE: $$259.00 (Due on or before your anniversary date) <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 />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />_ _ _ . land,. reclamation accomRlished to_date and during the preceding year, new disturbances that a_re 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 vour revised written annual report and annual report map 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 vear and no <br />new changes to the previous year's map are necessary, then no new map is required provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />d~elj'neates and includes the above elements may since or a written report. <br />~(/CJ GZO/l lT/U~ S 42. ('4~~FrT/Q~'~'~ 7G Cv2/Z~.vT ~'y'~ /f <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: P.O. Box 3007 <br />1676 Rhine Court <br />Phone Number: <br />Fax Number: <br />Montrose, CO 81402 <br />(970) 596-2425 <br />(970) 249-0731 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attac o this form along with your written report and map. Annual Report instructions are <br />enclosed <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />M:~PERMIT~MASTERDOCLJMENTS/M-AF-02. DOC <br />