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ANNUAL FEE and REPORT RE UEST <br />PERMITTEE NAME: ?'Iichael Browning <br />PERMIT NO.: -2003-072 <br />OPERATION NAME: Wet Canyon Mine <br />ANNIVERSARY DATE: December 19, 2010 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Las Animas <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`suGmit`thz--zrrrnuai-feed -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 vour 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 vear'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: Michael Browning <br />Permittee Name: <br />Michael Browning <br />Address <br />16503 CR 31.9 <br />P.O. Box 93 _ <br />Phone Number: <br />Fax Number: <br />Weston, CO 81091 <br />(719) 868-3621 <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 />Signature of Corpora Officer, Owner or/Designee <br />Date