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Y <br />._ <br />• III III III III IIII III • <br />999 <br /> <br />Notice of Intent to Continue Mining Operations <br />112 Annual Report ~ ~ ~ ~ ~ ~~ <br />Permittee Name: Caldwell Brothers „)qY 2 9 i99~ <br />Permit No: M-86-016 <br />Operation Name: Caldwell Brothers 3 MINEp ~giyp <br />Anni versary Date: 06/01 /90 ~i`CLAMATIOPI DIVIC~, <br />Total: E350.00 (Due on your Anniversary Date) <br />Please return this form with your completed Annual Report, map, and a check <br />or money order for annual fees due, payable to the Colorado Mined Land <br />Reclamation Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br />ANNUAL REPORT: <br />a~~~~ <br />Signature <br />~~,~~ <br />