Laserfiche WebLink
J ~ <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Total: <br />• • <br />~~ <br />Darryl D. Stout <br />M-79-103 <br />Amick <br />04/08/90 <br />• ~~~ei! ~ <br />III III III III IIII III <br />'~i~R :31 i:39~) 110 Enclosure <br />'~INEU LAWS <br />;EC «., <br />E50.00 (Oue on the Anniversary Date) <br />Please return this form with your completed Annual Report and a check or <br />money order for annual fees due, payable to the Colorado Mined Land Reclamation <br />Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br />ANNUAL REPORT: <br />///, r ,~ ~a a~u4.P cti <=~ S /te~rrt .~-v<:~ - ~-:, l 5 b' 9 <br />e~ <br />Signatur <br />I~C/ <br />Y <br />