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i <br />._..: ; iiiiiiiiiiiiiiiiiii <br />110 and 111 Enclosure <br />Permittee Name: Douglas Obannon <br />Permit No: M-80-201- <br />Operation Name: OBANNON PIT <br />Anniversary Date: 10 / 23 / 85 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) - <br />`~ S'~,c'C~ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />X Annual Report <br />Remarks: 2L~~ ~~~ti ~~~ . f~ <br /> <br />f c L lL~_o , ~c o .C,~ t,c /•.~ f Y- C. . ~r.-iv,:. L.~ ,%..~-~ ~ ~u <br />l' ~ ~.Z <br />.- , ~ <br />Signature <br />c L <br />~dliZl~'6~ <br />OYY~~ ~`0"~ <br />F~ (e. <br />~" <br /> <br />