Laserfiche WebLink
Clerk and Recorder <br /> Justin D Grantham, County Clerk & Recorder <br /> 615 Macon Avenue, Room 102 Canon City, Colorado 81212 <br /> Phone 719.276.7330 <br /> Fax 719.276.7338 <br /> justin.granthanO <br /> fremontco.com <br /> RE: MINING RECLAMATION PERMIT <br /> APPLICATION COLO STATE 34-32-112.10.8 <br /> DATE RECEIVE) 0 <br /> e <br /> NAME OF APPLICANT Poc,� , L.L <br /> PERMIT # / <br /> DATE OF HEARING <br /> NAME OF CONTACT PERSON: <br /> KeLCo Zrnnq phone # Ia-773-99X <br /> please print <br /> Please check which box applies to your permit: <br /> I wish to be contacted 30 days after the hearing to pickup the application <br /> I do not wish to pickup the application 30 days after the hearing and <br /> herby give the clerk's permission to d stroy <br /> "T Ca�,y� Signature 1 <br /> * SEAL <br /> o VV ate of Disposition Clerk <br /> 6/25/2020 <br /> V:\Recording\Forms\Forms\reclamation form.doc <br />