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• <br />III I ~~ ~ II' I~ II~~ ~~~ <br />999 ~~~~~~LiiAEnclosure <br />Permittee Name: Horn Ra Inc. AUG 12 198866 VV <br />Permit No: M-83-102 <br />Operation Name: Horn Gravel ~t MINED LAND <br />Anniversary Date: 08/02/88 fiECLAMATlON D!V!SlON <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />/ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br /> <br />Si ature <br />(R v. 06/88) <br />