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~rM <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Precious Offerings Minerals Exchange, Inc. <br />M-1999-074 <br />Brown Derby Mine <br />October 20, 2004 <br />~~C~,~~® <br />acr oa ~ <br />Division of rytinerals and ~aolagy <br />$225.00 (Due on or before your anniversary date) <br />Gunnison <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 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 ym~r revised written anmial rennrt and anm~al re,Pnrt main to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Glynda Yoder <br />Permittee Name: Precious Offerings Minerals Exchange, Inc. <br />Address: 200 Alder Ln. <br />Boulder, CO 80304 <br />Phone Number: (303) 544-1188 <br />Fax Number: (303) 442-3822 <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 />M:~PEIiMIT\MASTEADOCUMENTS/M-AF-02.DOC <br />~D- (o' 0~ <br />Date <br />