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<br />RECEIVED <br />Permit No: 77-345 (Boettcher Sandstone) <br />oc~ n ~ ~9E~a <br />MINED LAND RECLAMATION DIVISION <br />Anni versary Date: October 10, 1984 Colo. Dept. of Natural Resources <br />Operator: <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: <br />_ Check or money order payable to Colorado Mined Land <br />_ Reclamation Division for annual fees due <br />~ Annual Report <br />Map <br />Remarks: 110 Permit in Temporary Cessation <br />~r <br />Signature p. E. 'ihonsen <br />Senior Mining Fhgineer <br />