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' ~ M <br />~- s _ s <br />• III III III III IIII III <br />999 <br />Permit No: 80-49 <br />Anniversary Date: February 18 <br /> <br />MRR 1 3 1982 <br />Operator: <br />MINED LAND RECLAMATION <br />Please complete the following and return this form with your fee~pi~n~e~t Os ~~9tL'!zl P.e50!~fCE <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />Check or money order payable to Colorado Ptined Land <br />Reclamation Division for annual fees due <br />Notice of Intent to Continue Mining Operations <br />Remarks <br />Signed, <br />~1~ 1 <br />3I p ,~ ~~, <br />~~ <br />