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III ~II'llllllllllll <br />~J <br /> <br /> <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Total: <br />Notice of Intent to Continue Mining Operations <br />112 Annual Report <br />Dorn Ready-Mix Corp. <br />M-74-092 <br />Barlow Pit <br />10/31/90 <br />5350.00 (Due on your Anniversary Date) <br />Please return this form with your completed Annual Report, map, and a check <br />or money order for annual fees due, payable to the Colorado Mined Land <br />Reclamation Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br />ANNUAL REPORT: <br />,~.a S 2k.L. W/~°- ~ - ,6L,.t;~..o0 «.-v~..x-t+.~-P-r-~..D- ~~'9 r f- s ~ <br />~~---0 <br />Sig ture <br />~~~" .~ <br />1J <br />r\ <br />~: ~ ~ ~ <br />i ~ ,y .tea. <br />~`,~`~\~ <br />