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f <br />/, <br />Permii:tee Name: <br />Permit: No: <br />Operation Name: <br />Anniversary Date: <br />• • <br />~~~ ~ ~ ~~~nclosure <br />Ca restia Trucking Co APR 1 5 1987 <br />M-81-036 MINE=D LAND <br />Ca restia Pit C~ECLAMATION DIVISION " <br />04/02/87 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />x Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Remarks' Map of area mined for 1986 <br />Signature <br />(Rev. 02/87) <br />5257E <br />cF~~,,n~~8"~ <br />_'1`'~" <br />~~ <br />_~~ <br />