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ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Gold Eagle Mining, Inc. v0_ ED <br />PERMIT NO.: M-1977-248 13 2009 <br />OPERATION NAME: C-JD-5 DiVW <br />D'nrK+" of flecl8m9tion, <br />ANNIVERSARY DATE: June 16, 2009 Mining and Safety <br />ANNUAL FEE DUE: $633.00 (Due on or before your anniversary date) <br />COUNTY: 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, reclamatiorra=mptMre-d-toztat"nzl uriny th-c-prece-ding year, new disur ances thaare anti6fpa ed-f o-- - <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 vour revised written annual report and annual report may 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 necessary, then no new map is required, provided that the <br />erator 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: Don Coram <br />Permittee Name: <br />Gold Eagle Mining, Inc. <br />Address <br />Phone Number: <br />Fax Number: <br />If you have <br />below or at <br />enclosed. <br />P.O. Box 3007 <br />?=t. <br />Montrose, CO 81402 <br /> <br />(970) 249-0724 2 <br />(970) 249-3292 7a - 4? 7 <br />t? comments and/or information that should be provided to the Division, please provide it <br />is form along with your written report and map. Annual Report instructions are <br />Officer, Owner, or Designee <br />l <br />/ r /') 0,6 <br />Date <br />M:PERMITIMASTERDOCUMENTS/M-AF-02.DOC