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<br />~~~ II~II~I~~II~~ ~I~ <br />sss <br />Pennittee Name: zigan Sand and Gravel <br />Permit No: M-83-084 <br />Operation Name: Snowstorm Placer <br />Anniversary Date: July 28 <br /> <br />111/112 Enclosure <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />~- Annual Report <br />^~ Map <br />Remarks: check to M_r.RD already rlel i ~e red by Dan T. w in. <br />Signature <br />(Rev. 02/87) <br />5257E <br />