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MOFFAT COUNTY CLERK AND RECORDER <br /> 221 W. Victory Way <br /> Craig, CO 81625 <br /> (970) 824-9104 <br /> MINING/RECLAMATION FORM <br /> fil <br /> File Number p< <br /> Drawer Number <br /> Return Date 30 <br /> dn4o <br /> Date -s c g l ey! 201 to <br /> Received From oti Lehf« e)n I r, )4 4,�ru�of C v�dwyJ <br /> Mailing Address_ _ 5 / �{� ���✓cc y �-� <br /> lyk,e, Cc) 8�2� <br /> Mining'and Reclamation Application for: <br /> Name of Pit or mine: I ei/50,-) f i f <br /> Date on which inspection period is over and application may be retrieved by <br /> Applicant: _ �c� Aa <br /> ..._._. <br /> Agent Sigpature: T <br /> 'Attest: County Clerk or Deputy: <br />