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_ , ~' <br />Permittee Name: Southwest Properties, Inc. <br />Operation Name: ~~: ~ / aL~f ~r~„a~~/~ <br />Permit No: 81-158 <br />Anniversary Date: January 26 <br />M <br />110 and 11] Attachment <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />~~ Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />~ Annual Report <br />.r, h~ G[I ILA G/~~ /It~S.~ ML/!^ .S AO Y- S~ ~n C~~ YM iAY C. <br />~~Q- ~,/50 S1Xa~~~ ~~~ .'dp C~.1~ Cam.-.!z-- ~ ~f" r~., QS <br />{~o ~~.,~ .,~~ ~ roc%.~.r.J~ ~-L /9d`f. <br />Sig <br />(Rev. 5/84) <br />Doc. No. 1782 <br />