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• - ~~ iii iiiiiiiiiiiii iii <br />110 Enclosure <br />~~~!~ <br />O CT 91981 <br />Permittee Name: M(NEp U-ND <br />Permit No: pouglas O'Bannon Mp~'IONb1JISlON <br />Operation Name: (~ECLA <br />Anniversary Dat~~II~80-201 <br />b~Bannon Pit <br />10/23/87 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />,~,D •e 0 Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />!' / <br />Signature <br />(Rev. 02/87) <br />5257E <br />