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a~ ~-~2PL <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Denison Mines (USA) Corp. <br />M-1997-032 <br />Van 4 Shaft <br />November 3, 2008 <br /> <br /> <br />,w~c1D .. .,:.• <br />R4 ti _ <br />$518.00 (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, areport-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 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 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 />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: Christy Woodward <br />Permittee Name: Denison Mines (ITSA) Corp. <br />Address: 1050 17th Street, Suite 950 <br />Denver, CO 80265 <br />Phone Number: (303) 628-7798 <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 i to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signatu of Corporate Officer, Owner, or Designee <br />d <br />Date <br />M:~PERMITIMASTERDOCUMENTS/M-AF-02.DOC <br />