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04 ~~~ <br />~~ 7Q <br />Hi (-1 O <br />~ 'r ~ ~ <br />~B76 <br />a6nirC D Lamm <br />Governor <br />pile iva: <br />Operator: <br />i.fat~: <br />$a2C1d115L: <br />$11Dj2CU <br />• • iii iiiiiiiiiiiiiiii <br />DEPARTMENT OF NATURAL RESOURCES 999 <br />David f:. Getches, Executive Director <br />MINED LAND RECLAMATION DIVISION ~ <br />DAVID C. SHELTON, Drrretor <br />I,y OC Oi InLer dCLlJn: i•12 °_L1nG, PflOne, -Utn~er: 1l <br />~ersun(5) Oontacted and ~+friliation; /I iZ.f~ ~~i.S <br /> <br />(rev. ~/d3) <br />Uoc. ivo. 572J <br />423 Centennial Building, 1313 Sherman Street Denver. Colorado 80203 Tel. (303) 8oo-35oi <br />.hcMO TJ IL= - ~ r-t <br />- - ~~ . <br />