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III IIIIIIIIIIIII III <br /> 99 <br /> RECF,,� Ene <br /> JUN 71988 <br /> Permittee Name: Nelson Construction;Inc MINED LAND <br /> Permit No: M-78-208 J RECLAMATION DIVISION <br /> Operation Name: Shaffers Crossing <br /> Anniversary Date: 06/16/88 <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 /> Annual Report <br /> Remarks: OuF Va TIA s/nu/ Qan.✓ eR <br /> A MA ola miNi/v4 er NCIIAAtoa oe. Nns droy Dais �w n1a Iasi% V nge <br /> Ala A&FA i5 n4tA/a e6 I/i 7- 7d L!.aeT�,PcclAm 7,-,k, A4 � ,-,cT- <br /> Signat e <br /> (Rev. 02/88) <br /> 257F <br /> 0052f <br />