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.. <br /> <br />Permit 1vo: 80-27 <br />Anniversary Date: FebrUdry <br />Operator: <br />~IIIIIII~IIIIII~II~ <br />sss <br />~~ <br />Please complete the following and return this form with your fees and reclamation <br />data. <br />Enclosed are: (Check box(es)) <br />RECEIVED <br />Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due FEB 2 F ~g83 <br />~' Annual Report <br />MINED LAND RFCLAAIATION <br />COLO. DE71. OF NATC.'J.L RESOL';tCES <br />Signed, ~~ //~`~~~,v~'J ' <br />