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PERMI TTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />FEE an PORT REQUEST <br />AN a <br />"' Gold Eagle Mining, Inc. <br />--"M-1977-248 <br />C-JD-5 <br />June 16, 2008 <br /> <br />RED r?V & D <br />.JUN 18 2008 <br />11ation, <br />$iv?siuz1 cE cie <br />Mining and Safety <br />$$633.00 (Due on or before your anniversary date) <br />Montrose <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 />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 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 may. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous -year's may are necessary, then no new may is required, 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 suffice for a written 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 <br />Address: <br />Phone Number: <br />Fax Number: <br />Gold Eagle Mining, Inc. <br />P.O. Box 3007 <br />8 45 E. M __ ift C, t-. <br />Montrose, CO 81402 <br />(970) 249-0724 <br />(970) 249-3292 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or a h ' his form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />aL? <br />Date <br />M:PERMITIMASTERDOCUMENTS/M-AF-02. DOC