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<br />Notice of Intent to Continue Mining Operations <br />112 Annual Report ' <br />Permittee Name: Asphalt Paving Company <br />Permit No: M-83-089 <br />Operation Name: Tomah Site <br />Anniversary Date: 11/08/90 <br />Total: E350.00 (Due on your Anniversary Date) <br />Please return this form with your completed Annual Report, map, and a check <br />or money order for annual fees due, payable to the Colorado Mined Land <br />Reclamation Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br />ANNUAL REPORT: <br /> <br />!~I ~~1~ <br />Si ature <br />If your address has changed in the last year please inform this office below: <br /> <br />