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110 and Ill Attachment <br /> Permittee Name: Blue Jet Mining Company <br /> Operation Name: �UE��r <br /> Permit No: 78-135 <br /> Anniversary Date: September 4 <br /> Please complete the following and return this form with your fees and <br /> reclamation data. <br /> Enclosed are: (Check box(es) ) <br /> Check or money order payable to Colorado Mined Land <br /> Reclamation Division for annual fees due <br /> Annual Report <br /> Remarks: Q?( ) Z -2CGo7`>S 1 )3DtCIAaC 1�141 <br /> -T- <br /> Signature ✓lLG <br /> (Rev. 5/84) <br /> Doc. No. 1782 <br />