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--,~ <br />... • III I II I II I II IIII III • ~ ~e rvlo n <br />~~ . <br />Permittee Name: <br />Permit No: Ralph Carestia <br />Operation Name: M-81-036- <br />Anniversary Date: CARESTIA PIT <br />04/02/86 <br />110 and 111 Enclosure <br />E7 6Vn~ ~ r r •_.W~^~ <br />~~c~~ J <br />it y L'_y ~~ <br />APR 171986 <br />Please complete the following and return this form with your fees and <br />reclamation data. M(~d~F~ O.AtJ® "1~;:.~ln~lir~?~lti~:V <br />Colo. Dopt. at r:2'.°_`: k) 9~t~:59ufCCa <br />Enclosed are: (Check space(s) below) <br />x _ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due Check Ik2042 - Paid 4/7/86 <br />x Annual Report <br />Remarks: I have mined less than 1 acre of ground in 1985 <br />and have done no reclaimation. I will mine 1 acre of ground <br />in 1986 and will start to reclaim some of the worked area. <br />Signature <br />/af~b ° ~a~ <br />y ~'~i r U <br />