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iii iiiiiiiiiiiu iii <br />Permittee Name: <br />Permit No: Berthoud Pink Stone <br />Operation Name: M-81-(157- <br />Anniversary Date: SPRAGUE-RED LYONS <br />06 /10/86 <br />• <br />110 and 111 Enclosure <br />!~ .. . <br />JUM 1 y (g8o <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclose/d are: (Check space(s) below) <br />/ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />} <br />Remarks: <br />Annual Report <br /> <br /> <br />6(2c1~ <br />~,$- <br />F, c~ <br />i <br />