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:. ~.~ • <br />• :/. ~rl 7 <br />\. ~~ <br />u ~_. r..-,. - <br />APR 2 1 1983 <br />Permit No: 78-222 <br />Anniversary Date: f1arch <br />Operator: <br />Co!c. Dept. of ~~'a[urzl Rcso~~~c?~ <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 the Colorado Mined Land <br />Reclamation Division for annual fees due 3 /1~~ <br />Annual Report ~S~ c. b~~ ~ w l <br />Remarks~~ o~.~ c.onS~ cQ e-C '~1~ cS as ouC' ~~ N off, c~ o~ ~ ~~'Y.r'{~ <br />'~ C.orl~'IrIU.E- M`~~'llriq ~,nQ.,'S4.~lOh~ -FO C- T1-~c~ Cdrr,~no ~CLQ.C. <br />A~oX~rr,a.~c~ti b_Z c,cc~S ~~~r~ c,~~.cp-1-¢.c~ cQ.u,c~n« ~1n ..D~c.r~,,nG <br />U Q,~ K' - A'1 D 1 cx+t'1 C~ _ W Q S 'C'(c.. 1L~ Gi ~Lrn Q, Cl . ~ n ~ .~. r.~ ~ .l . ~,r-7 u,r,-~( J <br />Y/1, ~'l~r~G CCC~JIt~. 4~3¢-C-'~~~--~c, GDOU.V ~Q. ~c~r/1 ~. GMO wc~~ OT~ <br />~Urc~ tS ¢~~QC-~cc~ _c~u.Sino ~rc cot,-, ~n4 ~-{ QQC: <br />c ~ A m c cy. C~ , _L_. r\t c . <br />S <br /> <br />~. <br />Signature <br />