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6M L VA, <br />f E RMITTEE NAME <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Colorado Calumet Co. Mining <br />June 30, 2010 <br />$$259.00 (Due on or before your anniversary date) <br />Teller <br />MWEVED <br />SUN 07 2010 <br />Dh ivien of ? ¢ciarnsvon, <br />/ Mining and Safety <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, 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 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 vear's map are necessary, then no new map 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: <br />Permittee Contact: <br />Permittee Name <br />Address <br />Phone Number: <br />Fax Number: <br />Bryan K. Lees <br />Colorado Calumet Co., Inc. <br />490 Orchard St <br />P.O.Box 1169 <br />Golden, CO 80402 <br />(303) 278-9724 <br />(303) 278-9763 <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 />ignature o Corporate Officer, Owner, or Designee <br />A 4A-1 13, Z©ZD <br />Date <br />ANNUAL FEE and REPORT RE UEST <br />?Co orado Calumet Co. Inc. <br />-2006-034 <br />4 <br />M: \PERMITIMASTERDOC UMENTS/M-AF-02. DOC