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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Rocky West Mining Corp. <br />M-1982-058 <br />Poorman Mine <br />June 14, 2002 <br />RECEI!/ED <br />MAY 0 7 2002 <br />Division of Minerals and Geology <br />$225.00 (Due on or before your anniversary date) <br />Clear Creek <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 />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. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following pemtittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Alvin Mosch <br />Permittee Name: Rocky Wes[ Mining Corp. <br />Address: <br />Phone-Number: <br />Fax Number: <br />Box 3236 <br />Idaho Springs, CO 80452 <br />(303)569-4565 <br />1. ~ s .P A ~ ~-- <br />Qr~ hit io- - t S S A ~ ~ w~.i <br />N° G6~~~~=S {~S , lv <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 repoR and map. Annual Report instmctions are <br />enclosed. ~~ ~ ---~ <br />~~ e ~li I'N ~ 7~ <br />Signature of Corporate Officer or Owner <br />s - - ~~ <br />Date <br />~'o !L ~ ~o ~eti~X ,+yi.w~ <br />~s N ~ ~ ~a-f G ~ s T <br />~ I~2 .._ f+ O JrL /A~ <br />M:~PERMI'M]ASTERDOCUMENTS/M-AF-02.DOC <br />