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ANNUAL FEE and REPORT REOUEST MAY 2 6 2009 <br />Q z Division of Reciwnzticwj, <br />PERMITTEE NAME: Mineral County ? Mj*kQ and Safety <br />PERMIT NO.: M-1984-097 ? <br />OPERATION NAME: Mineral County Pit <br />ANNIVERSARY DATE: June 28, 2009 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Mineral <br />Accords to C.R.S._34-32.5-116_or_C.R.S. 34-32-116 each year. on the anniversary date of the_ermit, 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 map. If no new disturbances or reclamation have occurred during the previous year and no <br />new chances to the previous year's map are necessarv, then no new map is renuired. 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: Leslie Cahill <br />Permittee Name: Mineral County <br />Address: P.O. Box 70 <br /> Creede, CO 81130 <br />Phone Number: (719) 658-2360 <br />Fax Number: (719) 658-2931 <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 />enclosed. <br />Signature of Corporate fficer, Owner, or Designee <br />boo <br />- /?? ?z <br />Date <br />M: \PERMITIMAS TERDOCUMENTS\M-AF-04