2001-10-04_REPORT - M1999074

• Permit No: M1999074
• IBM Index Class Name: Report
• Doc Date: 10/4/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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999 OCT 0 4 2001
ANNUAL.FEE and REPORT REQUEST Division of Minerals and Geology
PERMIITEE NAME: Precious Offerings Minerals E=bange,Inc-
PERMIT NO.: M-1999-074
OPERATION NAME Brown Derby N km
ANNIVERSARY DATE: October 20,2001
ANNUAL FEE DUE: $225.0(Due on or before your anniversary date)
COUNTY: Gtmnisop
According to C.R.S. 34-32.5-116 or C.RS. 34-32-116. each year, on the anniversary due of the permit, an
operator shall submit the annual fee, a report and tap showing the extent of carrent disturhances to affected
land reclamation accomplished to date and during the preceding year. new disturbances that are anticipated to
occur during the upcoming year,reclamation that will be performed during the coming year, the dates for the
beginning of active operations,and the date active operations ceased for the year,if any.
Please attach your revised written atmoal reoort nod amnal report man to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permitter Contact: Glynda Yoder
Permittee Name: Precious Offerings Minerals Exchange,Inc.
Address: 1044 St.Hwy. 325
Rifle.CO 81650
Phone Number: [phone]
Pax Number. [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are
enclosed
Signature of Corpo a leer or Owner
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Date
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