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f\ ? Ar/ ?V-K <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Blue Jet Mining Inc/ <br />PERMIT NO.: M-1978-135-HR ? <br />OPERATION NAME: Blue Jet Mine <br />ANNIVERSARY DATE: September 9, 2008 <br />ANNUAL FEE DUE: $259.00 (Due on or before your anniversary date) <br />COUNTY: Moffat <br />RECE?VF[all <br />AUG z 1 Mo <br />Division of Reclamation, <br />Hning and Safety According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator 0?k <br />shall-submit the-annual--fee,-a-report and-map-showing-the-extent-of cunrent distarbairces-to-affe-ctedland, rec am"1 a i?'n <br />accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the <br />upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active <br />operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report may to this form. The Annual Report & <br />Fee requirement is not met until we have received the following components: fee, report, and associated map. <br />If no new disturbances or reclamation have occurred during the previous year and no new changes to the <br />previous vear's map are necessarv. then no new map is required, provided that the Operator shall state this in <br />the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above <br />elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Orvie Zimmerman <br />Permittee Name: Blue Jet Mining Inc <br />Address: P.O. Box 181 <br />Craig, CO 81626 <br />Phone Number: (970) 824-6467 <br />Fax Number: (970) 824-8884 <br />If you have additional comments and/or information that should be provided to the Division, please provide it below <br />or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of C rporate Officer, Owner, or Designee <br />s-/ l.), / ;7, o0 R- <br />Date <br />M: \PERMITkMASTERDOCUMENTS/M-AF-02.DOC