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iii iiiiiiiuiiiiiii <br />~,_., ~ ~. <br />i 111 /112 Encl [o~spuree <br />Permi ttee Name • Al bert Frei & Sons ~ ~ ~ ~ fi '(~ <br />Permit No: M-81-202SG <br />Operation Name: Silt Pit 'DEC 17 1986 <br />Anniversary Date 11 / 27 / 86 <br />MINED LAND - - <br />f?ECLMMATION DIVISION <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 }p ~p~lpu~ <br />Map }u ~p~~0~ . <br />Remarks: <br />ignatu <br />ca/I~i~ <br />M -ter- a ~ a. <br />qn. ~ ~- <br />I"[~ ("r, <br />