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<br />I?ECEIVED <br />• JAN 08 ;gA~ <br />L11NED LAND R€CLAMATIpN DIVISION 110 and 111 Attachment <br />Colo. Dept. of Natural Resources <br />Permittee Name: Lawrence Construction <br />Operation Name: <br />Permit No: 74-41 <br />Anniversary Date: January 15 <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 />~~ Annuai Report <br />~, T ~POJEn To ~~PivlC~b~,/ ''Woo ocuv~z„p Co,rsyQvc7loti/ Coo <br />Remarks: AN.v~sa-L ~E/'a/~~i ,' /(/ori~G oX ~,c.Yea~r , <br />~9Aio AffCCrc tJ ,~,.~i !i!y ~2 /roees bPa-e. ~9Bf 5~ ~d o ~ SEe . <br />29 YG 5 , iQ68W or' Trf~ / rf ~iy !.U %~oC/~io5 ~~~r7Y, ~lei~~n, <br />GUS cxT~xr~o .9>//'Qasc. /oo,uw i~v o!= ,S,s~vo .gvn G~.9ucG • l,c' <br />Ti/C l3~v~f~ it /~~ ,``~ G(lits /-v A.v :4.C'cf~ o!=- 2.5b ~x 'ooo <br />.~/Lf /48.5 ivy -s~inc~Ld Proc/v~e FI/'/~ i'~,~'. /oD,ooo Tc+~ udTt~1= T!f[- <br />/3 L vrF iN ~y ,¢2t ,c~ o F A-/~/~/.'c x X60 ~ x ~0 00 Tie Ta/~ -f~ ~ L <br />a(/GS ~c syc'~1P ~ LY,t~/J ,Sq L~ E O 70 ~ E ~e/~ 4. l G!> L ~-TSa' , <br />~/~CU/ <br />Signature <br />J ; CD <br />~ ~~~ <br />(Rev. 5/84) <br />Doc. No. 1782 <br />