Laserfiche WebLink
• III III III IIIIIII III <br /> 999 <br /> Permit No: 78-352 <br /> Anniversary Date: April 11 <br /> Operator: <br /> Please complete the following and return this form with your fees and reclama- <br /> tion data. <br /> Enclosed are: (Check box(es)) <br /> Check or money order payable to Colorado :Mined Land Reclama- <br /> tion Division for annual fees due <br /> Annual Report <br /> .Map <br /> Remarks <br /> o n o 1 9 1922 <br /> MIN ' <br /> rm& Dept. of Natural Resources <br /> 1 <br /> Signed, �/j <br />