Laserfiche WebLink
._, <br /> <br />Permit No: 81-207 <br />Anniversary Date: Februd <br />~ III IIIIIIIIIIIIIIII <br />~~~ <br />~~ <br />Operator: <br />Please complete the following and return this form with your fees a,^d *ec_'a,-a- <br />tion data. <br />Enclosed are: (Check box(es)) <br />0 <br />Check or money order payable to Colorado Mined Land Reclama- <br />tion Division for annual fees due <br />Annual Report <br />Map <br />r.C'oC 2-c,'J <br />signed, <br />//~aC~ ~: <br />RiCt;VED <br />PfAF' ~ ~ 133 <br />µ.n r~ LAND RECLAMATION <br />... ~_ ~ OF MTI..lAL R SOI:'.CLS <br />