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<br />Permittee Name: Penn Mountain Mining, Inc. <br />Permit No: M-85-022 <br />Operation Name: Bullger Basin Placer <br />Anniversary Date: 05/23/88 <br />111/112 Enclosure <br />Please complete the following and return this form with your fees {lnd <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />Check or money order payable to Colorado Mined Land Reclamation <br />~SU.[~U Division for annual fees due <br />J <br />Annual Report <br />Map <br />Si nature <br />8099G <br />Remarks : 7-lt,.e ~..~ tf~ 5 ~fti /~~o z9 c f i /~ Tom. /~r3 7 <br />T- <br />a>3aJ ~ mT I !i ~L T ~ w~ _ A-t~w~-e ~ s _~~r~w~-~ Fob l t 4S SS <br />