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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY' DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />A F *- ?2? F- <br />ANNUAL FEE and REPORT REOUEST <br />Elmo Nossaman ??? <br />M-1982-020 / ? <br />Sooner Lucky Strike Mine Ltd <br />May 25, 2009 <br />L/ ?j <br />$259.00 (Due on or before your anniversary date) <br />Gunnison <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 />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 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: t/ to the best of our knowledge <br />PermitteeContact: Elmo Nossaman no work at mine 2009 with 'the exception of <br />clean up & maintenance. No reclamation <br />don Expect to run mill in 2009 <br />Permittee Name: Elmo Nossaman <br />Address: P O Box 15449 <br />Oklahoma City, OK 73135-5449 <br />Phone Number: (405) 736-1019 <br />Fax Number: 4 0 5 741-1215 <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 />F en <br />ignature of Corpor, to Officer, Owner, or Design e <br />4-20-2009 <br />Date <br />M: TERMIIIMASTERDOCUMENTS/M-AF-02. DOC