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<br />Permit No: 31-235 <br />Anniversary Date: April 22 <br />Operator: Chalres J. Webster for Estate of Ellis B. Webster and Charles J. Webster <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 />~~ Annual Report <br />Map <br />