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(JPEG Image, 1694x2337 pixels) - Scaled (33%) <br />https:Hmail.google.com/mail/?ui=2&ihc38ffi008e&view=att&th=1... <br />f +4' ?l <br />AANNUAL FEE and REPORT REOUEST <br />LrP <br />PERMITTEE NAME: / B- Mining Company •V/ 5 E i 3 O O <br />PERMIT NO.: Y/ M-1986-102 Div1!fi n u F'Tc B <br />OPERATION NAME: Deep Creek Placer "lift Qnd <br />ANNIVERSARY DATE: September 4, 2010 <br />ANNUAL FEE DUE: $313.00 (Due on or before your anniversary date) <br />COUNTY: San Miguel <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 operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year,-new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Daniel L. Collins <br />Permittee Name: B - Mining Company <br />Address: 1417 S. Grandview Dr. <br />Tempe, AZ 85281 <br />Phone Number. (480) 894-6211 <br />Fait Number. <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 enclosed. <br />ignature cf otporate Officer, Owner, or Designee <br />-! I °i) <br />Date <br />I of 1 9/812010 4:57 PM