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• <br />Permittee Name: Bumgardner Rainches, Inc. <br />Permit No: 80-27 <br />Operation Name: <br />Anniversary Date: February 2 <br />~ III IIIIIIIIIIIII III <br />~ ~ <br />4' <br />110~r~ re (~ <br />F€@ 141985 <br />MiHED WID IlE4LM~~i~9Al 91VI~IOH <br />0010• Dept # liV L~ <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 />