Laserfiche WebLink
t~J <br />Permittee Name: John F. Triantos Jr. <br />Operation Name: <br />Permit No: 78-304 <br />Anniversary Date: November 13 <br />• <br />110 and 111 Attachment <br />~µ,. <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (check box(es)) <br />~~ Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />~~ Annual Report <br />Remarks: ~/.4 /~,eo/ ~AV„s,J~ ~,,,,cc,~,C Q,,erw~~ ~._ <br />~L O w i i! ~, ~ n <br />Signature <br />(Rev. 5/84) <br />Doc. No. 1782 <br />/~(!~/~y <br />~(~ <br />~- <br />RECEIVED <br />DEC 1`; 1°a=~ <br />MINED LAND RECLAMATION DIVISION <br />Colo. Dept. of Natural Resources <br />