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/1 <br /> <br />V~~],Q Enclosure <br />RECE1 D <br />Permittee Name: <br />Permit No: Vida S Solberg APR 071981 <br />Operation Name: M•-81-044 ~ ' <br />Anniversary Date: JE~ns 0 Sol Pit MIN~p~p1`1D <br />0~I/07/87 R~G~MgT10N D1VISlON <br />Please complete the following and return .this form with your fees and <br />reclamation data. <br />Enclosed are: {Check space(s) below) <br />~_ Check or money order payable to Colorado Mined Land Reclamation <br />Divisiun iur- annual Tees due <br />Annual Report <br />Remarks: ltenort will be sent no later than ?1av 15. 1A87 <br />Signature <br />(Rev. 02/87) <br />5257E <br />~~7~~7 <br />~" ~;~ <br />._~- <br />