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<br />Permittee Name: ~-ou ~yn`a'"~-- <br />Permit No: I?l$3-037 <br />Operation Name: j,~y ntfi-~~ ~"~ <br />Anniversary Date: S-3%-£~l <br />` ~ ~ ~~ sss <br />~~/~Ce 110 Enclosure <br />JUL 311987 <br />MINED LANU ~S~ <br />[?FCC AMAT!ON DIVISION ~ ~ /~~~ <br /> <br />~ec~, p-~ ~ o~~~ <br />Please complete the following and return this form with your fees and ~,3 ~,~, <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 />~ vV\. <br />Signature <br />(Rev. 02/87) <br />5257E <br />~(~~ S ~~ <br />~ ~~~~ <br />~` (~ <br />~- <br />