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999 <br /> Permit No: 77-438 <br /> Anniversary Date: November 1 <br /> Operator: <br /> Please complete the following and return this form with your fees and <br /> reclamation data. <br /> Enclosed are: (Check box(es)) <br /> Check or money order payable to Colorado Mined Land <br /> Reclamation Division for annual fees due <br /> Notice of Intent to Continue Mining Operations <br /> Remarks 1 wcv// LI/I f TG 'A.1ai,/n ycc� i1", i,v/rn/ A (°a.vl,*Z e <br /> li//,i_: I✓ /7ffI // Z do ,v//aI/ /Nelu /P I'mor he- e Tl e�r <br /> /S NO ('li'.v�P in/ SOX//'PP Of Z"I X( -(,1// 1,re-W <br /> /yq:z . i lAn/.,/ 5/r,Wrr <br /> Signed' <br /> 1/u1/2CliL'S %/Li/L l el - <br /> c <br /> 011 IVY <br />