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• <br />* iii iiiiiiiiiiiii iii <br />110 Enclosure <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Fred L. Korinek <br />M-79-131 <br />Korinek S&g Pit <br />07/27/88 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclo/sea are: (Check space(s) below) <br />v Check or money order payable to Colorado Mined Land Reclamation <br />- Diroisiun for anneal feesdae <br />Annual Report <br />Signature <br />(Rev. 06/88) <br />0052f <br />r,u c ~ )9aa <br />N!lNED L.Nlvu <br />f1ECLAMAllG~1 DIVISION <br />`/fkf -l <br />CY h c" iJ ." <br />F~~ ~,~ I~~R~,~F~ <br />5',SD ~nF /S <br />/~la~~~~,o~; ~~ <br />pia S.Y <br />