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c7 — — - <br /> o �^1 Clerk and Q(fcorder <br /> FREMONT COUNTY <br /> P. O. Box 349 Carton City. Colorado 81212 Phone 303 275-1522 <br /> Norma Hatfield <br /> Cowry Cje.r S Flecorder <br /> RE: MINING RECLAISIATION PERMIT APPLICATION <br /> Coto Stat. 34-32- 112. 10 . 8 <br /> DATE RECEIVED : 3115 �9 �j,, <br /> RAVE OF APPLICANT:(�.�� �" � . ' O"c kd— c� <br /> DATE OF HEAPING: <br /> PLEASE CHECK WHICH BOX APPLIES TO YOUR PERUTT <br /> I WISH TO BE CONTACTED FIVE DAYS AFTER THE HEARING TO <br /> PICK UP THE APPLICATION. <br /> THE NUMBER AND PERSON TO CONTACT IS : <br /> yi= _ 9,�Z-9t 7B -- -- <br /> I DO NOT WISH TO PICK UP THE APPLICATION FIVE DAYS AFTER <br /> THE HEARING AND HEREBY GIVE MY PEPMTSSION TO THE CLERK ' S <br /> OFFICE TO DESTROY . <br /> SIGNED : <br /> � is . <br />