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<br />112 Enclosure <br />Permittee Name: Corn Construction Co ~~ ~+ ~°~~~ <br />Permit No: M-79-089- <br />Operation Name: 23 Road Pit /1U~ 1 8 <br />Anniversary Date: 07 / 25 / 86 <br />MINED LAND <br />gECLAMATION DIVISION <br />Please complete the following and return this fottn 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 />~-r ~l~w Annual Report <br />Map <br />~ Remarks• .9ppr~,~,',.~~( ly If,erc <br />T/.;s .vea~/;n~ <br />W~s )ChCJr,/-ri~- c, `!, was ~,,,,~~ ~.:,;,~y ~L.~ Pr~~~~s /'°~~ , <br />ror.:.~f~r owe acre <br />h ~d~~pp <br />~rca7 <br />P;~ <br />ft <br />G~:~t c61ZrU<Drcl No Ic. (.... /.'e.- 1/ <br />/ <br />/r ~3 ]~~%„ ~/aim l <br />-rUii..S TI.. P~Sf `fP>Y <br /> <br /> <br /> MINED V ~ RECLAMATION DIVISION N 0 7 7 8 2 6 <br /> 13~~Sherman, Room 433 <br /> Denver, Colorado 80]03 D.arE ~is <br />(303) 866-3567 <br /> RECEIVED FROM <br /> THE SUM OF LLARS $ ~ ~ ~ ~~ <br /> 0 oCK <br />~ 7 ~ <br />- <br />~ ~ <br />~ <br />~ <br /> / r / <br />\(Y~/In <br />" <br />1 ~~ <br />FOR f <br />~0 <br /> <br /> AMOUNT OF ACCOUNT...... $ ~^Nf^ /~ Iou~ <br />` <br />( <br />A <br /> \ <br />f <br />AMOUNT PAID ................ $ <br /> ~ <br />BALANCE DUE ............... $ BY - <br /> <br />cY(I b'(8Z <br />~-~-~- <br />~~r~ <br />