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_... <br /> <br />Permit No: 77_546 <br />Anniversary Date: ~„ly 26 <br />Operator: `~~/~C~ <br />Please complete the following and return this form with your fees and p' ~_ ~/~ <br />reclamation data. 0 _ O <br />Enclosed are: (Check box(es)) <br />% Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />_ Annual Report <br />Remarks: Overburden moved and pit started <br />