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<br />Permittee Name: Pridemore Construction, Inc. ~~~~ ~ ~~ <br />Permit No: M-84-043 JUL Q g ~gg~ <br />Operation Name: Jesse Lee <br />Anniversary Date: 07!25/88 MIN~pLANp <br />RECLgMAT'ION gIVI51pN <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />XX Check or money order payable to Colorado Mined Land Reclamation <br />_ Di-vis-ion-for-apnea-l-#ees-dae- - ------- J <br />- - ~ ~ ~~iiii~iiiii~~ui~i <br />110 Enclosure <br />Annual Report <br />Remarks: Annual Report to follow with in two weeks. <br />Si gne <br />(Rev. 06/88) <br />0052f <br />