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r <br /> <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Henderson Dev Co <br />M-80-110- <br />HENDERSON DEV <br />09/09/85 <br />i <br />~. ~ III IIIIIIIIIIIIIIII <br />112 Enclosure ~ ~ <br />ilk i <br />~~ <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />,iY Check or money order payable to Colorado Mined Land Reclamation <br />-- Division -fdr annual-fees due -- ~ - - <br />xx Annual Report - See Below Explanation <br />Map <br />Remarks: <br />This permit is being suoerceeded and amended by application M-80-110. <br />please refer to that file for information regarding last years mining <br />activities. <br /> <br />Signature <br />NOt/12 ~9S <br />M/p~p~o Naua RM N <br />AT10 <br />sources <br />