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C <br />• ~ ~ ~ 7 _~ <br />uPR '? G ~.~..-3 <br />110 Enclosure <br />' - iVi1NED Litiiv.. <br />Permi ttee Name: Dave Di rezza ~titC~. agAATION C1!v '" <br />Permit No: M-84-028 <br />Operation Name: Di rezza Pit <br />Anniversary Date: 05/01/90 <br />Total: E50.00 (Due on the Anniversary Dat ) <br />Please return this form with your completed Annual Report and a heck or <br />money order for annual fees due, payable to the Colorado Mined L nd Reclamation <br />Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203 <br />ANNUAL REPORT: <br />//JE.QE `J~45 ,(~Pe~ /70 qc~%iui% /~l/-f7~iF~ / yE71~ <br />r ' <br />Signature ~~ ~.' <br />