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05/24/2010 09:32 FAX <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />IA002/002 <br />i?? * M--t' <br />ANNUAL FEE and REPORT REQUEST <br />Gold Eagle Mining, inc. <br />M-1977-M- <br />C-JD-5 <br />June 16, 2010 <br />RECEIVE[) <br />t/ JU( 13 Zola <br />e%. D'Wslon Of Re <br />$633.00 (Due on or before your anniversary date) <br />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, reclamation accomplished to date and during the preceding year, new disturbances tbat 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 />lease 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 necessary, then no new map is required, provided that the <br />Operator shall state this In Lhg 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: Don Coram <br />Permittee Name: Gold Eagle Mining, Inc. <br />Address: P.O. Box 3007 <br />845 E. Main St. <br />- - --_. Montrose, CO- 81402-- <br />66LZ2 L,: ¢ (-P.107 /•yI yL <br />trig !Ke67 <br />Phone Number: (970) 249-0724 ?' ?9 fv - d Z <br />Fax Number: (970) 249-3292 Q7Q -?'- 07 / _ <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />T orm along with your written report and map. Annual Report instructions are <br />below or attach/, <br />enclosed. <br />Signature o rporate fficer, Owner, or Designee <br />/,-> e A 0 <br />Date <br />U\PERD 911MASTMU30CUMGNIS/M-AF-02.llOC