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1 <br />• <br />Permittee Name: John Dillop <br />Permit No: M-86-165 <br />Operation Name: Willow Bend <br />Anniversary Date: 08/27/88 <br />Please complete the following and return this form with your <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />_~ Check or money order pdyable to Colorado Mined Land <br />Division for annual fees due <br />110 Enclosure <br />s and <br />lamation <br />~ Annual Report <br />Remarks: ~~ ' <br />i <br /> <br /> <br /> <br /> <br /> <br />~1 <br /> <br /> <br />REC <br />AU G 2 <br />r~~r~ ~~/ED <br />21988 <br />INE <br />Signatur <br />RECLAMATI <br />(Rev. 06/88) LAND <br /> <br />N DIVISION <br />0052f <br />