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III III III IIIIIIIIII 110 Enclosure <br /> Permittee Name: 999 E <br /> WED <br /> Permit No: David Bacon & Glenn Southwick MAY 1 8 1987 <br /> Operation Name: M-86-007 <br /> Anniversary Date: Masonville Stone MINED LAND <br /> 03/11/87 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 /> Signature <br /> (Rev. 02/87) S/ �/� 7 <br /> 5257E <br />