PERMFILE66055

• Permit No: M1986006
• IBM Index Class Name: Permit File
• Doc Date: 1/15/1986
• Doc Name: LIMITED IMPACT 110 & SPECIAL TEN DAY 111 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

MINED LAND RECLAMATION DIVISION N p ~ ~ 5 2 g
1313 Sherman Street Room 423
Denver, CO 80203 DATe /,5~ is .~~
[phone] (~ ~'t~a[
RECEIVED FROM~(~A/Rt~~~!• ~~L-~ f` ~~ _
THE SUM OF rV AtP F / ,~L~Py O~fU7'~--DOLLARS $ f /- o~
~~,,c//ns.
PM1y/~ECK
FDR -~~~~ n'i - ~ ~ ooc~ io~,~ ~ Mo
AMOUNT OF ACCOUNT...... $
Hand ~ou~
AMOUNT PAID ......... ...... $ _
BALANCE DUE .. $ _ - 8V _ - ~*~~a~--