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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />fvp i- RI l <br />ANNUAL FEE and REPORT REOUEST <br />V'/CRG Mining, LLC <br />M-1987-143 <br />Gold Links Mine <br />July 13, 2011 <br />RECEIVW <br />,/ JVN 13 ?Q11 <br />..{?/ Divisign of Reclamatipn, <br />C/ Miring and saftty <br />$259.00 (Due on or before your anniversary date) <br />Gunnison <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 />._--- ODeratQ Shall s> limit thejaiiuual=fa <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 vour 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 durine the previous year and no <br />new chanLyes to the previous vear's map are necessarv. 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: Robert Gydesen <br />Permittee Name: CRG Mining, LLC <br />Address: 502 S. Wisconsin Street <br />Gunnison, CO 81230 <br />Phone Number: (970) 596-4520 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />.th your written report and map. Annual Report instructions are <br />below or attach it to this form alo7P <br />enclosed. - l 1 6? /il , yt `vy ?L <br />Signature of Corpo ,Pde Qf icer, Owner, or Designee <br />Date <br />M: PERMITIMASTERDOCUMENTS/M-AF-02.DOC /" C/ <br />/? O /