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i <br />} <br /> <br />Permittee Name: Mine Development, Inc <br />Operation Name: <br />Permit No: 81-1E,5 <br />Anniversary Date: Octot,er 2 <br />I~CEIVED <br />110 and 111 Attachment <br />PAINED LAND RECLAMATION DIVISIOPI <br />Colo. Dept. of Natural Resources <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box{es)) <br />I_I Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />I_I Annual Report <br />Remarks: <br />Signature <br />(Rev. 5/84) <br />Doc. No. 1782 <br />