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• iii iiiiiiiiiiiiiiii • <br />999 RECEIVE®Enclosure <br />Permittee Name: George Speer DEC 17 ~j <br />Permit No: M-83-176- <br />Operation Name: SPEER DEVELOPMENT M~HEQ LAMD i1ECLAMATION <br />Anniversary Date: i2 / 09 / 85 Co10.0~pt.Q(11/tUfdAMOYfpeB <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />X Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />X Annual Report <br />X Map <br />Remarks: <br />waA.,.~,,,, <br /> <br /> MIS LAND RECLAMATION DIVISION N 0 0 ~ 5161 <br />f313 Sherman Street Room 423 <br />CO 80203 <br />SS S <br />D <br />~ <br /> enver, <br />~B <br />DATE <br />(303) 8663567 (I n <br />r <br />C <br />~ <br /> 1 .Y ~t-G <br />~n~ <br />I t\ [mil L S! <br />RECENEO FRO-~{M <br />`\ <br />~ <br />S <br />C <br />~~ / <br /> ~ <br />~>~oOLLARS $ <br />~ <br />V <br />U <br />THE SUM OF 1~Y~d~ <br />(~ G~ (I (~ ^ CnS+ <br />O cK <br />I t7S <br />M - S3 ' I ~ L <br />~ <br /> 5 <br />G <br />DO <br />FOR {~\S~'LM <br /> AMOUNT OF ACCOUNT...... $ <br />~l I <br />I <br /> oU <br />(~J I`QII~ <br />AMOUNT PAID ............ ... $ / <br />~ <br />~ <br />/ <br /> P-cJ KL~9 <br />(~ <br />BALANCE DUE ............... $ BV q! <br />Signature <br />