Laserfiche WebLink
i <br />• • <br />Permit No: 80-27 <br />Anniversary Date: February 2 <br />G~~~~~~j I~, <br />Operator: <br />Please complete the following and return this form with your fees and <br />reclamation data. trilP;=O L(,h'D ntCLA4^(1TIC' C'.'~h~lOPl <br />Celo. Depi. of Iva+ural F:~_u.irces <br />Enclosed are: (Check box(es)) <br />!~ Check or money order payable to the Colorado Mined Land <br />_ Reclamation Division for annual fees due <br />`~ Annual Report <br />~~ ~~ z~ ' /~C- ~c ~ C ~-~C/ ( -G ~ t C`z-c, L ~~1~'~~c CL.ic-~' I ,/,~:~"c~`c~-~ <br />