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~, <br />II I II~IIIIIIIII~III REC~Iy~D 1 2 Enclosure <br /> Dakolios Const Co AUG 19 eggs <br />Permittee Name: M-84-036- <br />Permit No: DAKOLIOS PIT NO 1 MINED LAND HEGLAMATION <br />Operation Name: <br />Anniversary Date: 04 / 30 / 86 Colo. Dept. of Netural Resourtee <br />Please complete the following and return this form with your fees a d <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />Check or money order payable to Colorado Mined <br />Land Reclamation Division for annu 1 fees due <br />Annual Report <br />Map <br />Remarks: <br />~l~ s /cQz <br />. ~-` "~' <br />~-~`~ <br />