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~~ ~-~ ~ ~ ~ III IIIIIIIIIIIIIIII <br />~~ ~ ~ ~~a$ ~losure <br />Permittee Name: Don Kehn Construction J U L ~ 1987 <br />Permit No: M-86-074 <br />Operation Name: Dollerschell MINED LAND <br />Anni versary Date: 06/30/87 RECLAMATION DIVISION <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />~_ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Remarks: <br />We nlan to do mining at this pit, however sae do not have a date <br />scheduled at this time. <br />(Rev. 02/87) <br />5257E <br />/~/ ~ 7 <br />~' /~9 <br />~j~ <br />_~ <br />