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?- ?p ? <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Blue Jet Mining Inc <br />PERMIT NO.: M-1978-135-HR"?'® <br />OPERATION NAME: Blue Jet Mine AUG 2 0 2009 <br />ANNIVERSARY DATE: September 9, 2009 ?j Division of ReclamatiOR, <br />t% Mining and Safety <br />ANNUAL FEE DUE: $259.00 (Due on or before your anniversary date) <br />COUNTY: Moffat <br />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 <br />- operatorshall-s,zbmit-the-annual fee; a report-and map showing-the-extent ofcurrentzlisturbances to- affected. <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred durine the previous vear and no <br />new chances to the previous year's map are necessary. then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above 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: _ (9 7 0) 82 4 - 50 4 9 -- <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report a map. Annual Report instructions are <br />enclosed. <br />Signature of Co+6rate Officer, Owner, or Designee <br />Date