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' T ~ • <br />Permit Plo: 81-2 <br />Anniversary Date: _July 15 <br /> <br />operator: J U L 2 2 1982 <br />Please complete the following and return this form with you};~IE~~sI~n'i~7iecl~a~tn~a~~~~~~ <br />data. Cn~O. ~8p:. 01 N3t_~ir~~ P^SO'!f.4` <br />saclosed are: (ChecF: box(es)) <br />Check or money order pauable to Colorado Mined Land <br />~~ Reclamation Division for annual fees due <br />Annual Report <br />siyned, .~_ <br />/ ~/ V <br />Q~r <br />