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~~ <br />~ ! 110 Enclosure <br />Permittee Name: Southwest Properties <br />Permit No: t4-31-158 <br />Operation Name: Forest Lakes Pit #1 <br />Anniversary Date: 01!26/89 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check spac:e(s) below) <br />J,4!I 2 71°~~ <br />x Check or money order payable to Colorado Mined.Lar~;R,eclama~,i_gn <br />Division for annual fees due ;~ECLt;r:.t'~,-.~ '~ <br />Annual Report <br />Remarks: <br />(a) No land affected during the previous year. <br />(b) The land to be mined during the coming year <br />is Forest Lakes Pit #1 - Permit #M-81-158. <br />(c) No land reclaimed during preceding year. <br />G'/G ~R--~--~~ <br />Signature <br />~~/ <br />