Laserfiche WebLink
' ` ., III IIIIIIIII IIII III <br />999 <br />Permit No: 77-558 ~~~~-+~~~~ <br />Rnni versary Date: February 22 ~ HR 1 1 X582 <br />PAINED LAND RECLAMATION <br />operator: Colo. Dept. of A~atral Reso!~rce~ <br />Please complete the following and return this form with your fees and reclama- <br />tion data, <br />Enclosed are: (Check box(es)) <br />Check or money order payable to Colorado Mined Land Reclama- <br />® ti on Division for annual fees due <br />Annual Report ~ /~ /9/Q. <br />Q Map ~/~ /yp~ <br />Remarks <br />Signed, <br />