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ANNUAL ]ME jWd REPORT REQUEST <br />PERMITTEE NAME: Nuvemeo, LLC <br />PERIANNO.: M-197&222-UG MAR 0 12011 <br />OPERATION NAME: Monogram Mines Division v, ntw4amation, <br />Mining and Safety <br />ANNIVERSARY DATE: March '1, 2011 <br />ANNUAL FEE DUE: $1,150.00 (Due on or before your anniversary date) <br />COUNTY: 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 feew, 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 attackvmurevised written annual report and annual resort 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 map are necessary, then no new map is required. provided that the <br />Operator shall state this in the Annnal 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: Henry M. Carter <br />Permittee Name: Nuvemco, LLC <br />Address: 1 077 1-3200 Road <br />Hotchkiss, CO 81419 <br />Phone Number: (970) 872-3247 - <br />Fax Number: 91 6 8 7 2 3/ Z Z <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 />enclo <br />S' ature of Corporate Officer, Owner, or Designee <br />Date <br />M'VgM aPMMTMU)OCIYMFSMM-AkA2.rxOC