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<br />-~ ' iii iiiuiiiiiiiiiii '` ,~ <br />999 <br />RE11O,,,~d,~,]~Encl osure <br />Permittee Name: Jelen & Son, Inc. ` t~ V t <br />Permit No: 83-11 FEES 21 ~~~'' <br />Operation Name: WILLOW CREEK MINE <br />Anniversary Date: February 23 MINED IAND RECUMAiIf1~J ©i+/IBl9ti <br />Colo. Dept. Of Na3ur81 RQSplli~ <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />roc Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />~; Armual Report: During 1984, only sapling and assessment work was done. <br />~ignatiure <br />