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~ Ill lllllllllilll III • <br />((~~yy~, -, _. .. _110 Enclosure <br />l~'~? ; ` _ <br />Permittee Name: Jelen & Son, Inc. i ~ ~; :~ i,~.~) <br />Permit No; M-83-011 <br />Operation Name: Willow Creek Mine , <br />Anni versary Date: 02/23/89 -; -~~_; ,.~, ~ <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />X Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due Standard Coal Co¢¢:any check ~p1071 <br />Annual Report <br />Remarks: Exploratory, satr~ling and testing work done in 1988. <br />Signature <br />(Rev. 06/88) <br />0052f <br />