Laserfiche WebLink
<br />----- -- - <br />~I I I I~ I I~ ~ II II~~ ~I~ <br />110 and 111 Attachment <br />Permittee Name: Louis M. Wyman <br />Operation Name: <br />Permit No: 83-37 <br />Anniversary Date: May 31 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />~~S' Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />I_I Annual Report <br />Remarks: <br />Signature <br />AUg pi 198q <br />Docv.No/84782 M °~~OP~ofNdAMat~t? oDIVISI r <br />tur 0 <br />rces <br />