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<br />Permit No: 76-51 <br />Anniversary Date: Mav 8 <br />Operator: Cecil E. & Kenneth D. Bettger <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />~~ Gheck or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />~~ Annual Report <br />~ Map <br />Remarks <br />j <br /> <br />