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<br />RECEIVED <br />PERMITfEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNL? AL FEE and REPORT REQUEST <br />Gold Eagle Mining, Inc. <br />M-1978-342 <br />Ellison Mlne <br />February 15,2002 <br />FEB 1 9 2002 <br />Division of Minerals and Geology <br />$225,00 (Dux on or before your anniversary date) <br />San Miguel <br />Accorcling to C.R.S. 3432.5-116 or C.R.S. 3432-t16, each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and trap showing the extent of current disturbances to affected <br />-land, reciamation accomplished to date and during the prec~dinn year. new dishubmtres that are antici;-Hied tr <br />occur during the upcoming year, reclamation chat will be perforrtted during the evmittg year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach vmtr revised written anneal renort and nnnuail report map to this form. Plc~nse norr that a+i <br />nclaqucrzuly luhrled m yT dicuf~c{'/Iran~rly flcilnefne.t erns( if!rludcs lhr. abuvr ciwffunle' n!u~. .i:fff~r fur a urinrr, <br />YP/70Yr. ~O C L ' ~r u <br />Division records indica[e the following petmitree contact information. Please verify and make any nacesstuy <br />changes: <br />Permittee CentacL pon Comm <br />Permittee Name: Gold Eagle Mining, Inc. <br />~.. <br />Address: 845 E. Main St. <br />P.O. Box 3007 <br />Montrose, CO 81401 <br />Phone Number: (9tt1) 249-0404 <br />Fax Number: (970} 249-3292 <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 />enclosed. <br />~~~ <br />Signature of Corporate OfFicer or Owner <br />o ~--~~ s/d ~-- _ <br />Date <br />M:WERM^ iMASTERDfKUMEVT'S/M-AF-O? DOC <br />