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,. ° .. ... ~ RE~~I~~® <br />Notice of Intent to Continue Mining Operations <br />110 Annual Report SEP 1 g 19 <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Farnsworth Construction Co. <br />M-82-154 <br />Farnsworth Gr Pit 2 <br />. 90 <br />Mined Land <br />Reclamation Division <br />. •LI JY1~ VLL YG. <br />Total: 11/VJ/JV <br />$50.00 (Due on your Anniversary Date) <br />Please return this form with your completed Annual Report and a check or <br />money order for annual fees due, payable to the Colorado Mined Land Reclamation <br />Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br />ANNUAL REPORT: <br />A •~ <br /> ` 9 _ <br />,Q <br /> <br />t <br />f _ /~ 2.C Q rs-c~' <br />/J~ ~/ c o ~ o-~L <br />f <br />~ <br />~r <br />t <br />~ <br />~ <br />~ _~~p <br />~~~ .- <br />-tc.f.I <br />7 Gf > <br />, <br /> <br /> <br />J ^ <br /> <br /> <br /> <br />~~ <br />~ _' <br />Signature <br />If your address has cha/n~ged in the last yeJar please inform this office below: <br />~/9.P/I ~ _Si~~i~,P 7~ ~ ( i~.rJ.1',~l/CT7 D ~/ ~c <br />~ D ,5 ~~J i" L ~~D <br />~' l Q~~ <br />J <br />