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<br />., ~ <br />Permit No: 80-228 <br />Anniversary Date: <br /> <br />iii iiiiiiiiuiiiiu <br />April 27 <br />• <br />Operator: <br />PZease complete the following and return this form with your fees and reclamation <br />data. <br />Enclosed are: (CF.eck box(es)) <br />Check or money order payable to Colorado Mined Land <br />~~ Reclamation Division for annual fees due <br />Annual Report <br />Signed, _, <br />Q~c_S V ~ <J~ <br />O~ ~. R <br />~{^~. ~' <br />RECEIVED <br />APk 2 8 1982 <br />FdINFD LAND REC! A""4Ti0N <br />Colo. Dept. of Natural h,;sct,rce <br /> <br />