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<br />III IIIIIIIIIIIIIIII 110 and 1 1 <br />sss <br />Permittee tJame: <br />Permit No: So Way Co <br />Operation Name: M-84-025- <br />Anniversary Date: STAGE STOP PIT <br />07 j 26 J 86 <br />Please complete the following and return this form with your fees an <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />Check or money order payable to Colorado Mined Land Recla <br />Division for annual fees due <br />Annual Report <br />Remarks: ~,,,,,<a~ 2e ~ .~~ te,,~r Enclosure <br /> <br /> <br />~ ~' ~: <br /> <br /> <br /> <br /> <br /> <br /> <br />tion <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />c~~Clit~ ~ ' ~ ii~i~M <br />Signa re / <br />~a a <br />~C <br />~g <br /><¢ <br />