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ANNUAL FEE and REPORT REOUEST --, , , <br />1 ^^^ .. <br />PERMITTEE NAME: Denison Mines (USA) Corp.:-/ <br />PERMIT NO.: M-1997-032 <br />OPERATION NAME: Van 4 Shaft <br />ANNIVERSARY DATE: November 3, 2009 <br />ANNUAL FEE DUE: $518.00 (Due on or before your anniversary date) NOV O 3 2009 <br />COUNTY: Montrose ?j Divi?en of Rsc amaliota, <br />31 Mining and Sa%tY <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 maps owing?he 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 vour revised written annual report and annual report man 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 durine the previous year and no <br />new chances to the previous vear's map are necessarv. then no new map is reauired. 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: Christy Woodward <br />Permittee Name: Denison Mines (USA) 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 />belo4ef t to this form along with your written report and map. Annual Report instructions are <br />enclignporate Officer, O wner, or Designee <br />Aal <br />Date <br />M:\PERMITIMASTERDOCUMENTS/M-AF-02.DOC