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~\ <br />V' . <br />• III I~~'ll!I~'llll~l '"~~~ <br />MAR 61986 112 Enclosure <br />Permittee Name: La Poudre S & G Inc ~~~~~ ~~~ ~;~r~'rupATiO~! <br />Colo. Dept. of h.:.16a! Resou€ces <br />Permit No: M-83-090- <br />Operation Name: LA PGUDRE S & G INC <br />Anniversary Date; O1 / 17 / 86 <br />Please complete the fallowing and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />Check or money order payable tc Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Map <br />Remarks: It is necessary to obtain the information required <br />in the annual report from the Operator. Request has been made <br />and will follow within 4 weeks. <br />,, -_ <br />i <br />Signature ~ , . ,, <br />