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... ' iiiiiiiiiiiiiiiiiu ~ <br />999 <br />Permit No: R~_1 G~j <br />Anniversary Date: February <br />Operator: <br />Please complete the following and return this form with your fees and reclama- <br />tion data. <br />Enclosed are: (Check box(es)) <br />Check or money order payable to Colorado Mined Land Reclama- <br />ti on Division for annual fees due <br />Annual Report <br />Map <br />Remarks Annual report and maps will be forth coming on or before April 1, 1983 <br />Signed, <br />%~~~~~~ <br />~~~ <br />Robert R. Prevost <br />Vice President <br />Schmidt-Tiago Construction Co. <br />al~~l~3 <br />om _ ,~3 <br />FFD 1 C 1923 <br />L~ EAND RECLAMATIO'~ <br />~OFO, p Pte, OF NATO: A~ ~._ ' '~ <br />If ~~ <br />