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I~ <br />~ i <br />~ <br />I ll ll lll lll llll lll l~~n9 ~'~ <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />aaan~~~r ~ ,w,m <br />l 1988 1 0 Enclosure <br />~ pY ~ <br />Summit Brick 8 Tile MINE~~ND <br />M-85-203 ~ECLAMA710N C)IVI:'iION <br />Edmundson Clay Mine <br />05/09/88 <br />Please complete the following and return this form with your fees <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />x Check or money order payable to Colorado Mined Land Recl <br />Division for annual fees due <br />x Annual Report <br />Remarks: <br />No land was rec <br />n <br />during the last <br />~ ~~ <br />ion <br />Signature' ~ <br />Joseph ~Welte <br />8065G <br />