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16-AUG-2005 09:31 FROYFColarado Division of Ninsrals R Gaolosy +13036326106 T-369 P.002/002 F-784 <br />t ~- <br />A7VNilAf. FFF >,nd REPORT RF.OrfFST <br />PERMITTEE NAME: Mount Roysl¢ Ventures, LLC ~^ <br />PERMITNO.: /M-1994-117 AUG ~ Il 7,~n~ <br />OPERATION NAME: Gold Hill Mill ~ Division ci t;ir,~rai; 8 G;olop9 <br />ANNfVERSARX DATE: July 26, 2005 <br />ANNUAL FEE DUE: 5225.00 (Dne o0 or before your anniversary date) <br />COUNTY: Boulder <br />According to C.RS. 34.32.5-116 or C.R.S. 34-32-t 16, each year, on tlu Anniversary date of the permit, an <br />operator shall subnrit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclaa~tioa aceomplished to dau and during the preceding year, new disturbances that are anticipated to <br />occur during the upconung year, reclamation that will be performed during the coming year, the datrs For the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach year revived viritfvn annual rmmrt vnd annnal rertt'rt 1119p fn fhix farm- Please rsOte that ors <br />adequately labeled map tkat clearly delineates and includes the above elements may suffice for a writters <br />report. <br />Division records indicau the following permittee contact informadoa. Please verify and maim any necessary <br />changes: <br />Pecmittee Contact: Matt Collins <br />Permittee Name: Mormt Royale Ventures, LLC <br />Address: 9145 Sunshine t.,anyon Dr. <br />Boulder, CO 80302 <br />Phone Number: (303) 570-6269 <br />Fax Number: <br />If you have additional co~nents and/or arfottnation that should be provided to the Division, please provide it <br />below or attach it to this forth slang with your writtrn report and map. Amtual Repoli instructions are <br />enclosed. <br />Signs a of Corporate Offices, Owner, or Designee <br />~ ~ ~~ <br />Date <br />