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• • III IIIIIIIIIIIIIIII <br />999 <br />110 Enclosure <br />RECE~~~® <br />Permittee Name: Mitchell Concrete & Caisson Dr <br />Permit No: M-86-025 MAR 191987 <br />Operation Name: Mitchell Mine No. 1 <br />Anni versary Date: 03/19/A7 REC MINED LgND <br />LAMATION DIVIgION <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />V Ch~r_k or money order p?yeh1B to Colera~±o Mired Lind P.~clamsti~^ <br />Division for annual fees due <br />~ Annual Report <br />(Rev. 02/87) <br />5257E <br />3~r ~ 1~7 <br />~"~~ <br />~e <br />