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. .~ <br />~~~ • • <br />n i' <br />t~ E B 1 ~ 1986 <br />Permittee Name: Lawrence Const Co <br />Permit No: M-74-041- l'i~Se`~T~ ~-'~I~~'~ ~r'~-•~'•s:~:;i:~',~~ <br />Operation Name: LAWRENCE PIT q;p~p• ~~p4. Qf f-::"•'rF~'l~'SD~''G"" <br />Anniversary Date: O1 / 29 / 86 <br />iii iiiiiiiiiiiuiii` <br />999 <br />112 Enclosure <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check spaces} below) <br />Check or money order payable to Colorado Mined <br />Land Reclamation Division for annual fees due <br />Annual Report <br />Map <br />'! <br />/ ,~~ <br />/11, A <br />Remarks: S.';1~; ~ T (,f • ; ~ ~; - ~ •' `" <br />r-~ <br />IN ,,~ .. . <br />,~ <br />F~:~ i' l!' T /'1 ~~ ~ /~ J ~7`TJ G ~j l f : ~_ ~! '_,n " ,/: :~ •' T <br />~ ~~ <br />.~ ~~ <br />~. <br />Signature - (2 <br />- ~~ <br />~~ <br />