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<br />1"' . <br /> <br /> /~ 111/112 Enclosure <br /> <br />Permittee Name: Cotter Corporation ~"~ <br />m <br />~ 78 <br />1 <br />6 rr~ ~~ ~y <br />Ope <br />ation <br />Name: Sm <br />8 <br />M <br />ne ~8 <br />Anni versary Date: 10/30/88 irtC~~i,~:r~,r:.• <br />` <br /> •.., <br />,~~ ,, <br /> ,t <br />t~% ', :,_ <br />; <br />~r <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 />~~ Map <br />Remarks: <br />Signature <br />(06/88) <br />0054f <br /> <br />