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a'k-, - <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Mount Royale Ventures, LLC. <br />M-1983-141 <br />Cash & Who Do Mines <br />September 7, 2008 <br />$259.00 (Due on or before your anniversary date) <br />Boulder <br />SEP 12 2008 <br />L11vistot'6 V, Nt"'O;amation <br />mining and Safety <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 operator <br />shall submit the annual fee, a report-and map showing the extent of current disturbances to affected land, reclamation <br />accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the <br />upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active <br />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 Report & <br />Fee requirement is not met until we have received the following components: fee, report. and associated may. <br />If no new disturbances or reclamation have occurred durine the previous year and no new changes to the <br />previous year's may are necessary, then no new map is required,-provided that the Operator shall state this in <br />the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above <br />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: R T. Heard <br />Permittee Name: Mount Royale Ventures, LLC <br />Address: P.O. Box 19754 <br />Boulder, CO 80308 <br />Phone Number: (369-}5.1--349 ?? - 5(95 - ?S`1 `1E) <br />Fax Number: (720) 565-3497 <br />If you have additional comments and/or information that should be provided to the Division, please provide it below <br />or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Date <br />Owner, or Designee <br />M:IPERM r MASTERDOCUMENTS/M-AF-02.DOC