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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />?/? r <br />A,NNi1AL FEE and PORT REQUEST <br />9climax Molybdenum Company, Climax Mine <br />/ <br />6 M-1977-493 <br />OPERATION NAME: Climax Mine <br />d <br />eC S <br />ANNIVERSARY DATE: March 4, 2011 y? <br />ANNUAL FEE DUE: $$1,150.00 (Due on or before your anniver?'Xry date) <br />COUNTY: Summit <br />0,0t- <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 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 changes to the previous year'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: Fred J. Menzer <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number <br />Climax Molybdenum Company, Climax Mine <br />1746 County Road 202 <br />P.O. Box 68 <br />Empire, CO 80438 <br />(303) 569-3221 <br />(303) 569-2830 <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 />enclose . <br />Signature of Corp "e Officer, Owner, or Designee <br /> <br />M:IPERMITIMAS TERDOCUMENTS/M-AF-02. DOC