REV100619

• Permit No: M2003092
• IBM Index Class Name: Revision
• Doc Date: 10/12/2005
• Doc Name: Reclamation Permit Application Form
• From: Nick H. Gray
• To: DMG
• Media Type: D
• Archive: No

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P.O. Box 54'• Delta, CO 81476 :
[phone] • Fax: (970)'-874-3161. • e-mail: mvripp~aol.com /'~~~1 ~~ j~'~