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~ ~ III IIIIIIIIIIIII III <br />. Permit No:, 80-143 <br />Anniver:aary Date: October 27 <br />Opera to:^ <br />Please <:omplete the following and return this form with your fees and <br />reclara`ion data. <br />enclosed are: (Check box(es)) <br /> <br />Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />Notice of Intent to Continue Mining Operations <br />Signed, <br />~~ <br />