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110 and 111 Enclosure <br /> Permittee Name: Russell D Neesham <br /> Permit No: M-77-500-UG <br /> Operation Name: PEGGIE MINES <br /> Anniversary Date: 06 / 29 / 86 <br /> Please complete the following and return this form with your fees and <br /> reclamation data. <br /> Enclosed are: (Check space(s) below) <br /> Check or money order payable to Colorado Mined Land Reclamation <br /> Division for annual fees due <br /> /l-� Annual Report <br /> Remarks: /r�r„ 1 (n,41711iap --:�'7 ' 7i �r�TiDAS <br /> /�n �au � cy2s IIfYP-c r P�Cns u �r�vayirYIh� <br /> / � T n <br /> nA /-21r 1l A --e 4e2& J Te l-,v rs �-YerH;�,l e.rN�� L/77�,r 7Yl117 <br /> he <br /> Y'Z.Teycle/4' Qn/� / <br /> G/�7v� /�n n-� 7 �.s v1 2�/"n h ��L� .L�s �l S� '�✓ C e i— <br /> Signature <br />