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110 Enclosure <br /> Permittee Name: Nelson Construction Inc RECEIVED <br /> Permit No: M-78-208 <br /> Operation Name: Shaffers Crossing JUN 15 1981 <br /> Anniversary Date: 06/16/87 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 /> Remarks: Tf1E LUE5 d1PQA/ of Tf/E EYrA6(a*4?( A126A CAL' <br /> Cie C u4/c T dl TNi t --aR e� ,( x7:�_e1T AS <br /> ,rao.l 45 Pa,s R,erw /s <br /> Eocavess.v eP TlOE .ramr// .r.e/E G//L/ fayZ' ugo <br /> 40 <br /> Signs re <br /> (Rev. 02/87) <br /> 5257E fin^ g <br />