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<br />iiiiiiiiiiiiiiiiii <br />Permit No: 78-279 <br />Anniversary Date: November 22 <br />Operator: <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />Check or money order payable to Colorado Mined Land <br />© Reclamation Division for annual fees due <br />© Notice of Intent to Continue Mining Operations <br />Signed, C~C%J/(.Li~~C.C^%/L~ <br /> <br />V ~ y i i '7^ o, <br />v l~ ~~J~ <br />raa y 2 S 1982 <br />~~~~A~ pD LAND R`CL~IP/IgTICiV <br />Pt. of ll'3turat H°S~„rco~, <br />