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i ~ . y`` • • <br />Permit No: 79-2 <br />Anniversary Date: April 11 <br />Operator: Corn Construction Co. <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 />Annual Report <br />Map <br />Remarks %2P 7~ff~c~i e~~ j~t~ey <br />Signed <br />