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s s <br />1111112 Enclosure <br />~~~~~~~® <br />Permittee Name: <br />Permit No: Corn Construction Co APR 151987 <br />Operation Name: M-83-013 <br />Anniversary Date: Lathem - Burkett Pit MINtD LAND <br />04/28/87 fiECLAMATiON DIVISION <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 />Division for annual fees due <br />~~ ~~~ Annual Report <br />Map <br />Remarks: // m.n.n5 .:~ rCC /P.., /, o.+ /~~~ 7, ~c~ ~~a,/ .Ji+/in.~ ~ ~as~jr~1. <br />~Si~~.Ep: ~f-.f .e4, ~r,a 1 hs ~~~., tc,_o..- -r j`.~ .` ~ P~ c ~, ss. ~ ~s: ~r , <br />Signature" <br />(Rev. 02/87) <br />5257E <br />~~~-~~ <br />db <br />3Sb~ ~- <br />~~~ p/~55 <br />`7`/15/g7 <br />~_~~~~ <br />~~~ <br />