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• ~ ~ • III IIIIIIIIIIII III <br /> <br /> 110 Enclosure <br />S 4 a.J C~ om P4 h y <br />Permittee Name: u Q~ ~~~~® <br />Permit No: Olathe Pit <br />Operation Name: 12/14/86 <br />Anniversary Date: <br />DEC p21986 <br />nnINE LAND <br />~ECLAl1AAT ON DIVISION <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />_J~ Check or money order payable to Colorado Mined Land <br />Division for annual fees due <br />_~ Annual Report <br />Remarks: <br />O f}c rl v~T <br />lamation <br />~ a--(~-3 <br />~'~^ ` <br />Lass <br />~~~ <br />