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• iii iiiiiiiiiiiu iii , • <br />999 <br />~ri,F>s1~l~j~li4~1A'~ Enclosure <br />Permittee Name: American Materials Inc <br />Permit No: M-79-192 QCT' 9 <br />Operation Name: Spotted Burro Pit <br />Anniversary Date• 10/14/86 0 ~ .a~. ,,~y, +'"'s ~~' ~`fi;' <br />;~-~ n~ .rir 1^ <br />Please complete the following and return this form with your fees and <br />reclamation data. <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 <br />X Annual Report <br />Remarks : TAE~PF ,/AS .BEE'S Na ,N~nl iti/b .~a~e ,Qc C//9//io fio.r/ kl~~ <br />`lLtorn/~iisr/Ed p/~t~~/6 T~'E ~~l~~od.r PE',e~o.o , ~i°c~AS~o.JS ,trier <br /> <br />T,s . eEPozT d`f~}A SFR/F ,vt Ol/2 <br />LL .v0 ~`'~F OF <br />// <br />Ln TPnJ ~ T~/ <br />/ ~n wl Y/NU ~ /, <br />.(//. n/i ~/,C. ~OF~d.~L.C <br />_ / hi S / <br />Odln f-,n~. <br />rn~ ,e~,J /e~ss ~~F,/ ~~~ Sys ~~ >'E~ AND sus//d .do'~' <br />/7e Go../s ~ o ciz~o i,c/ f 16AA0O.~/0.rIE•/T, <br />Signature <br />/ 0~4~~~ <br />1?(c <br />