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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNN RSARY DATE- <br />ANNUAL FEE J)UF- <br />C;OUNTY: <br />ANN- L FEE and PORT REQUEST <br />punt Royale Ventures, LLC <br />-1983-141 <br />4ac?_' p/c <br />Cash & Who Do Mines <br />September 7, 2010 <br />S%259.00 (Due on or before your anniversary date) <br />Moulder <br />OCT RECEIViED <br />12 2010 <br />1--evision of Reclamation <br />Mining & Sa , <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 lie performed during the coming year, the dales for the <br />beginning 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 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 during the previous year and no <br />new changes to the previous year's ma are necessary, then no new man is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled maj; thal clearly <br />delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following penniuee contact infonnation. Please verify and make any necessary <br />changes: <br />Permittee Contact: R.T. Ileard <br /> <br />Permittee Name: Mount Royale Ventures, L.LC <br />Address: P.O. Box 19754 <br />Boulder, CO 80308 <br />Act; .e' ©.tZ'CE.s i-L-r- <br />1 is;so L.i `v?.?1 Sr - 5y ?1«-T00 <br />Phone Number: (303) 570-6269 30-3 -z- -SOS-7 <br />Fax Nurnher: (604) 605-0009 0 . -3 Q-L <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or att h it. to this form along with your written report and map. Annual Report instructions are <br />enclOW7 <br />or Designee <br />9-0615ic' Z010 <br />Date <br />M:\PERMITUASrERDO twF.N'rS/M-Al.p2I)(K <br />£/£ d 2£5LS86£0£ <br />Ca4.5-a p TAB v TO AG E) <br />« 90LSZ£8£0£ Swba 9£:LL 90-OL-OLOZ