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PERMITTEE NAME: <br />PERMIT NO.:. <br />OPERATION' NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />A ?- A- R('r <br />A_ffUAL TEE and REPORT REQUEST <br />5?calais Resources Colorado, Inc. <br />M-1994-057 <br />Hopemore Shaft <br />June 18, 2011 <br />RECEIVW <br />JUN 13 2011 <br />Division of Reclamation, <br />!4i'ining and Safety <br />$259.00 (Due on or before your anniversary date) <br />Lake <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 />ach your revised written annual report and annual report maig to this form. The Annual <br />Fee requirement is not met until we have received the following components. fee, regorw and <br />new ehanaes to the previous Year's may are necessary, inen no new mdp is reuuicru, urvviueu Luau euc <br />Operator shall state this in the Annual Report. Please note that an adequately labeled 7nap that clearly <br />delineates and includes the above elements may suf ce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact. Thomas S. Hendricks <br />Permttee Name: Calais Resources Colorado, Inc. <br />Address: 4185 Caribou Road <br />P.O. Box 653 <br />Nederland, CO 80466 <br />Phone Number. (303) 258-3806 <br />FaxNumber: <br />If you have additional comments andlor information that should be provided to the Division, please provide it <br />below or attagh it to this fort along with your written report and map. Annual Report instructions are <br />enclosed. <br />S <br />Signature of Corporate 0 er, Owner, or Designee <br />