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~ , • <br />Permit No: 77-302 e~ <br />Anniversary Date: October 27 <br />Operator: <br />PZease 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 />Q ti on Division for annual fees due <br />Annual Report <br />Map <br />Remarks Annual reports and Map to follow <br />Signed, <br />~ECEIVEI~ <br />NOV G i 1982 <br />NgNED LAND RECLAP~lATION <br />Colo. Dept. of Natural Resource <br />