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iii iiiiiiiiiiiu iii ~ <br />,,, ~~%I:r~ 6 r <br />Permittee Name: John McNulty FE a ,1.1987 <br />Permit No: M-80-003 Nif~tC <br />Operation Name: McNulty Cinder Pit I~tCLAN3AT1rJ~ D VI^~ <br />Anniversary Date: 01/23/87 ~.CN <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed a-e: (Check space(s? below? <br />_~ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />_~ Annual Report <br />Remarks : ~ ~/',~,_ ~..,_., ;._._ ~fc.~.. ~ ~.o.,,~ ..cu~-~...~ ,r,/..,,,.: <br />Signaturq/~~ Q/~ ~I~ <br />OYn•~~ <br />F<<~ <br />