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. _ k; <br />~~ <br /> <br />Permittee Name: Colorado Duarries <br />Operation Name: MICA LODE <br />Permit No: 77_144 <br />Anniversary Date: Nnvamhar an <br /> <br />110 and 111 Attachment <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />ICI Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />I_I Annual Report <br />Remarks: We have not this year, and do not anticipate next year to exceed <br />Permit limits. <br />Claim still active. No reclamation planned at this time. <br /> <br />Signature <br />(Rev. 5/84) <br />Doc. No. 1782 <br />