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999 <br />REC~~~~~ <br />Permittee game: F1obile Premix, Inc. NOV 15 ~9~ <br />Permit Mo: :4-77-057 <br />Operation Name: Fedinec Pit MINED LAND <br />Anniversary Date: 11/22/88 [~ECLAMATIONDIVI310N <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (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 />Signature <br />(Rev. 06/88 <br />0052f <br />