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• • iiiiiuiiiiiiiiiiii <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Blue Jet Mining Inc <br />M-78-135HR <br />Blue Jet Mine <br />09/09/87 <br />RECEI QED <br />SfF 101987 <br />AECLgMATIp 0 VfSION <br />110 Enclosure <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />D.n a ~ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Remarks: 7~ s 7%i9 ~ ~i . ~±`~e . - .> ~ r~ r~ c .- s J ~ ~ o n ~- ~~ /- <br />r <br />~~9><J~r' ni` ~iiJ~Y ~.(.~tLu>~ :~ i~H~ie~'ir~~ U!~.~ GrP_ <br />r ii ~ <br />1 <br />Signature <br />(Rev. 02/$7) <br />5257E <br />