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III IIIIIIIIIIIIIIII <br /> 110 Enclosure <br /> Permittee Name: Nelson Construction, Inc. <br /> Permit No: M-78-208 <br /> Operation Name: Shaffers Crossing <br /> Anniversary Date: 06/16/89 <br /> Please return this form with your completed Annual Report and a check or <br /> money order for annual fees due, payable to the Colorado Mined Land Reclamation <br /> Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br /> ANNUAL REPORT: <br /> (/Bey/ L,(77k- ,ocTi"11'Ty 7`//,s Aos7—yFAIL 441d de VoT- <br /> ,owTc.goaT Atejc/ rw/*syrwx . <br /> Qsv�y/Es 4xq VO /� <br /> — /?F'ddt/ (roa ,9M/1/ /REr �OGawl/W� <br /> 1 <br /> Sig ure �� <br />