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<br /> <br />• f <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Bucklen Equipment Co <br />M-82-131- <br />Bucklen Equipment Coif <br />09/20/86 <br />i <br />112 Enclosure <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />~'~u, (~ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />~•~/ Annual Report <br />Map <br />Remarks: S.<l~es ,¢•-e S~6w ~ ~oh 1 Y~~fiJi hike ~i Y)~c.~ ~,Ir,~~,~ <br />G' r {~9J1 ~ i k ~/F C 1 c~ r ~ ~. c 1 ~'1 I ~ ~ ~l ~'p -S C' / e F ~ ~ ~- l.~' R S <br />l ~ ~ i. <br /><'~o e k ~~ ~~ 5 <br />gna <br />