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<br />• ~ i ii ii iii iii iiii i ii i • <br />aaa <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Domenic Leone Const <br />M-85-008 <br />Leone-Gardner Gravel <br />03/22/87 <br />R E C ,~0 EnclosuDre <br />MAR 2 19\l8li7E <br />MINED I-AND <br />CLAMATI N DIVISION <br />Please complete the following and return this form with your fees ~nd <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />(Rev. 02/87) <br />5257E <br />3/~6~5~ <br />~i ~~ <br />_~_. Check or money order payable to Colorado Mined Land Rechamati~n <br />Division for annual fees due <br />~_ Annual Report <br />