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_; c <br />Permit No: 79-75 <br />Anniversary Date: f4ay 1'4' <br />Operator: Elam Construction, Inc. <br />/~¢ <br />,~y <br />~~ <br />RECEIVE® <br />MAv ]. 4 t~~:,~: <br />GAINED LAND Rr:CLP~AT10M 0!vICION <br />COIU. Uey1. UI ~Ve1w ~} ntl~u m.,ua <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 />Remarks _ lVOJJ I~OQk Wits ~~~uPH~c~ ial ~f/rs ,°~r ~~~~c~ <br />/9 ~ ~ . 1 ~0U 1 E/~ ~c!'r szJO ct:__g rs~ S*~,nk :9.4ciC : J <br />C~~ <br />