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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 />File Number ~ ~a 1 <br />Drawer Number <br />Return <br />~ 00 6 <br />Received <br />Mailing <br />Mining and Reclamation Application for: <br />G 2-~ <br />Name of Pit or mine: ~X ~~r f ~ t (,-/~,_(',-~ r G ~ <br />Date on which inspection period is over and application may be retrieved by <br />Applicant: <br />Agent Signature: <br />For: MyC-~-rk~ ~.!~/~/'f~ (~,~ n~ ~~ - <br />g^'r/•?~sws~rizl~l-!'.•'7MNi«~4+~'~7ui.!.+w+-s~•rce'-.•,. ., .,.~w-.!r~. -.'.6. -• _ ..a-e,~.,.. ..~.•. ....r ..-a..... .. .:•r. .. ... <br />Attest: County Clerk or Deputy: ~~~ ~'~-e_ !~(.~~d~-- <br />~~tLt ~ n~ M' S <br />