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<br />_. <br />110 an '~I~~is '°~ <br />I <br />Permi ttee Name : APR 14 ~~ <br />Permit No: Benson Brothers <br />Operation Name: M-77-062- <br />Anni versary Date: HALLENBECK PIT NO 1 ~~~~ ~~ RECl.AR9ATIfJIV <br />04 / 02 / 86 ~• ~ a Ngtx~l Rao,urc~s <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 annual fees due <br />Annual Report <br />~t ~ ~ ~- ~` <br />t% <br />Remarks: %~n. .rL.Y~ ~ .~ .. ~~i~./'n<O ~., ~ QJtltlrco- <br />