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<br />Permit No: ~0-203 <br />Anniversary Date: June 29 <br />Operator: <br />• <br />~,Jti~ 2 ~ 1982 <br />MINED 1.A~N RECLA~ Aou~Ce~ <br />Colo. DeP~. of Natural <br />Please complete the following and return this form with your fees and reclamation <br />data. <br />Enclosed are: (Check box(es)) <br />Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />XX Annual Report <br />Remarks <br /> <br />Signeu, <br />CARLETON CURRIER <br />BY: DUFFORD, 44AhDECK, RULAP7D, <br />WISE & MILBURN <br />By: <br />Richard H. Krohn <br />Attorney for Carleton Currier <br />900 Valley Federal Plaza <br />P.O. Box 2188 <br />Grand Junction, CO 81502 <br />Phone: (303) 242-4614 <br />