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r <br />' ~ • • <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anni versary Date <br />Total: <br />Exxon Coal and Minerals Co. <br />M-80-047 <br />Colony Shale 6i1 PRO <br />11/01/90 <br />E 275.00 (Due on your Anniversary Date) <br />Please return this form with your completed Annual Report, maD, and a check <br />or money order for annual fees due, payable to the Colorado Mined Land <br />Reclamation Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br /> <br />ANNUAL REPORT: <br />~i~nvs/ ~l~O~ /~! /99O ~~ 0'~2 s~6~si.~>~r/ ivi ../~7 /9~1/ <br />~~pWr~ ~ /~10~-t <br />Signature <br />If your address has changed in the last year please inform this office below: <br />Notice of Intent to Continue Mining Operations <br />112 Annual Report <br />