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:_ ~_ <br /> <br />Permittee Name: Robert J Kagie <br />Permit No: M-79-102 <br />Operation Name: Kagie Pit <br />Anniversary Date: 06/21/87 <br />R~~~a ~7 ~~ <br />JUN 151987 <br />MINED LAND <br />RECLAMATION DIVISION <br />~II II~II~II~~~I~ II~ <br />999 <br />110 Enclosure <br />Please complete the following and return this form 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 anneal fees due <br />i <br />Annual Report <br />:i <br />Remarks: -.G <br />SignatuMe <br />(Rev. 02/87) <br />5257E ~~(~ /~ 7 <br />~? w O~y~ <br />~' / 000 <br />