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>~ <br />:~ ~ • w <br />~GV~~{/C® 110 Enclosure <br />Permittee Name: Formaz & Son Inc G1AR 0 4 1987 <br />Permit No: M-78-305 <br />Operation Name: Dickerson Gran Pit MINED LAND <br />Anniversary Date: 02/22/87 (IECLAMATION DIVISION <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />g Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />g Annual Report <br />Remarks: The year of 1986 consisted of completion o£ reclamation and <br />closine out of Phase 1. The required survey was completed of the 9.9 acre _ <br />_ permitted area. The continued mining o£ Phase 3 in the year of 1986 will <br />contunue on into 1987. <br />gnature ~'~i <br />GYn . ~ ~~ <br />~~ r~ <br />