Laserfiche WebLink
• • iii iiiiiiiiiiiii iii <br />~~~ - <br />110 and 111 Enclosure <br />Permittee Name: <br />Permit No: Walsenburg S&g Inc ~ ~'"'"~ri~~:~-R-y~ <br />Operation Name: M-78-283- ~~"~ ;3"r`:'ai <br />Anniversary Date: SAND ARROYO <br />oa / za / 86 APR!~2 91986 <br />Please complete the following and return this form with your fe~~~ .,L,..,;,y,£,:+~,~ <br />reclamation data. ,;;~.~•.~ ~,~,;.~~)~CyS <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 />Remarks: ~~ ~~G ~~,GG~.~ a~ ~v ~~Gui ~-~. <br />Signature <br />~~~a~~6 <br />~~~~ <br />