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•# •~ <br />~, <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Corn Construction Company <br />M-78-323 <br />Webb Pit <br />11/22/88 <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 />5~•~ IS<%:., Annual Report <br />Remarks: /0 .+,,,,,;„~ <br />x` 1..,,> <br />or r« d~~„ lr~s ~~~„ pl;>~c- cluriny the y>5i ,e-.>i. <br />~~cc Yp,le 1 <br />!! P73 ~I.a/ 11 <br />I7'~3 Lt'rn R'nc.,t .! ~rL.. j'm P fc«SS~iK . S /~•- <br /> <br /> <br /> MINED LAND RECLAMATIdid DIVISION N 0 ~ ~ 9 ~ 2 7 <br />1313 Sherman <br /> Denver, Colorado 80203 DATE l~ _ 7 t9~ <br /> ////~~~~~~ (303) 8663567 _}-- ~~/ <br />$ <br />~ <br />~ <br />~ <br />ED <br /> \_~l'J~~1 <br />TYl.~1 (J~a.l~!' <br />T7~ <br />I ..Ll./.V(~J' <br />I <br />FR <br />O <br />M <br /> ~i rr <br />I <br />~ <br /> ,^ LL <br />~ <br />/ <br /> `d ~.! <br />~~i` ~ <br />ice' <br />DO <br />LLARS <br /> <br /> /y~ c (' g <br />~ <br />1 ~~/ - 7~'3~3 (o s~7 DMOECK <br />FOR CA..~:Cl1 ~~ <br />4- <br /> F <br />r <br />~ <br />1 <br /> ~ <br />~ <br />AMOUNT OF ACCOUNT. ... .$ <br />~ <br />I <br />~ <br />I <br /> ~N <br />2 <br />OU <br />AMOUNT PAID .................. $ <br />/ <br /> BALANCE DUE . ......... .......$ BY ~' ~ . <br /> <br /> <br />$1 <br />(Rev. 06/88) <br />0052f <br />/0 31-13 <br />110 Enclosure <br />.~~ L;.~ ~~. . <br />(~OV 71988 <br />nri1i~~.U ~.kP~lU <br />~ ttcLArA~ ~laF~ [±rrl~,lol~ <br />