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• • III IIIIIIilllllllll • <br />999 <br />Permittee Name: Caldwell Brothers <br />Permit No: M-86-016 <br />Operation Name: Caldwell Brothers 3 <br />Anniversary Date: 06/01/87 <br />~~~ Enclosure <br />JUL 91987 <br />MINED LAND <br />RECLAMATION 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 />Te (/~o-~+-cGt' <br />.~`~C o~n.~~z.. <br />Rio 3SS ~,, <br />,r,,rr,~. ~'u~ <br /> <br /> <br />Signature <br />(Rev. 02/87) <br />5257E <br /> <br />~/~~~~ <br />"YIL,~. <br />I y ~~~U <br />