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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <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 preceding year, new disturbances thatare`anticipated to <br />occur during the upcoming year, reclamation that will be performed during 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: Ryan J. McHale <br />Permittee Name: Venture Resources, Inc. <br />Address: <br />- Idaho Springs, CO 80452- - <br />Phone Number: (303) 619 -6323 <br />Fax Number: (303) 484 -6369 <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 />enclos <br />Date <br />Signatufe of 0 <br />rporate Officer, Owner, or Designee <br />7- (7- (( <br />PO Box 1974 <br />M:I PERMIT IMASTERDOCUMENTS /M- AF- 02.DOC <br />Apr <br />ANWAL FEE'and REPORT REQUEST <br />V nture Resources, Inc. <br />,z i -2008 -037 <br />Emma Lode MS #7261 <br />August 5, 2011 <br />$$259.00 (Due on or before your anniversary date) <br />Clear Creek <br />R CEIVED <br />JUL 2 2 2011 <br />Division of Reclamation, <br />Mining & Safety <br />