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999 <br /> 110 Enclosure <br /> Permittee Name: Andrews Mining il1hpany <br /> Permit No: M-77-438 <br /> Operation Name: Pickett Coral <br /> Anniversary Date: 11 /O11AW-19 8 7 � <br /> DEC 1 U 1967 <br /> Please complete the following and return this form with you�Rt3Land• 10� <br /> reclamation data. CiECLAM�'1 �01-j D1Vi5 <br /> Enclosed are: (Check space(s) below) <br /> sp `^ Check or money order payable to Colorado Mined Land Reclamation <br /> Division for annual fees due <br /> Annual Report <br /> Remarks: kurf rp SO.Od L'.4rr2P dut JJ-D/ B7 fo2 a///✓ 4XhU LSA�E/- <br /> fir 4 �nr� 3y}.ewi 3/1-32//J��f� a/` l'e%?.9�✓� AfiA//r LAiY/J��i���i�w�i�/i��eni N <br /> I Can/JJi eve �e d AAA" I, ssess...�./� d �n/l. o .w 4! e <br /> /11 R1ri,46 tO Ag/w//dA- 9A- OR_P <br /> Spero Are 2"al &JY'eel;w� d,,r/.v6 ce��iT.Q . <br /> A/o Z,441Z /r 7 o 6e dye /.mac A(e 4oa /C <br /> 6rN1 .[/o Z4XIV wil.s /?enl/&We/ 41,elVe //I�g• Oece:Ga:y6 Yes 0 <br /> Signature <br />