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• ~ III IIIIIIIIIIIII III <br />111/112 Enclosure <br />Permittee Name: ~'1~~~ ~~ ~~ <br />Permit No: Webster S b G V <br />~ Operation Name: M-81-235 1 1987 <br />Anniversary Date: west Tennessee APR 2 <br />04/22/87 <br />MINED ~AND~ tiS1ON <br />Please complete the following and return this form with your fees{~~MATION <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />~' Annual Report <br />Map <br />Signature <br />(Rev. 02/87) <br />5257E <br />r~/a(i ~~ <br />w~.~~~ <br />~~ <br />_r- <br />