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<br /> <br />A FEt an REPORT REOUEST V"W <br />MAY `I 0 2010 <br />PERMTTTEE NAME: Alvin,Mosch Patricia Mosch Diviaen of k*cianaaAloe?, <br />PERMITNO.; V4_19,82475 tAfr by stand SaOPERATION NAME: Phoenix Mine . . <br />ANNIVERSARY DATF,:. June 14,.2110 <br />ANNUAL FEE. DUE: $S259.00_(DDue?on,or before" our?anniversarv dater <br />COUNTY:;. Clear Creek <br />E <br />According to C.R.S. 34-32.5-t 16 or C.R.S 3'4=32 1 I6 each year, on the anniversary;date of the peimit; an <br />m_. ___... V. W. <br />operator st?ail su mitt cannual fee, a report and ii ap`showingtfie extent'"ofcurrent"disturbances fo 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 operationsy and the date active operations ceased for tl e;year, if any. <br />Please attach ottr'revised written anneal report.and anncral report mars to this form. The Annual <br />Report & Fee requirement is not met until we have-`received the follo`viug coariponents; fee, report, and <br />associated .ma , Kno new disturbances or reclamation have occurred du'r' ` the Previous ' year and no <br />new.chanp-es to the" Previous year's map are <br />>necessarv,. then no new map is repaired, provided that the <br />Operator shall state th%s in the Annual;Rebort. Please note that ari adequaiely'labeled wrap 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: Alvin M, h <br /> <br />Permittee Name: Alvin Mosch Patricia Mosch. <br />Address: Phoenix Gold Mine <br />P.O Box 3236 <br />Idaho Springs, CO 80452 <br />Phone Number: <br />Fax Number: <br />(303) 567-0422 <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 />- Z-W- <br />Signature of Corporate Officer, Owner, or Designee