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Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br /> <br />sss <br />Penn Mountain Mining <br />M-85-022 <br />Bullger Basin Placer <br />05/23/90 <br />~~~~ ~ <br />NPR 1 J ~a9'J 111 /112 Enclosure <br />MINED LHi~/ <br />ECLAMATItJt+1 ptq~ ~+~~~ <br />Total: E.00 (Due on the Anniversary Datep <br />Please return this form with your completed Annual Report, map, nd a <br />check or money order for annual fees due, payable to the Colorad Mined Land <br />Reclamation Division, 1313 Sherman Street, Room 215, Denver, Col rado 80203. <br />ANNUAL REPORT: (~_¢.. ~~ ~~ ~- ~~(,`~, <br />Ul' v~ <br />~r ~ <br />` .~a~-ems n <br />r <br />~ r~ <br />~ ~~ <br />~~ <br />r"` , <br />