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~ .~ <br />110 and 111 Enclosure <br />Loukonen Brothers l~"$~~~'~~® <br />Permittee Name: M-81-277- <br />Permit No: LOUKONEN BROTHERS JAN 1 5 <br />Operation Name: O1 / 11 / 86 <br />Anniversary Date: <br />!~3I;~~p fAPlD RECLAAgATtON <br />C~fo. DnpP. of Ply+~~e! fl~4.i:rc~~, <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />ov <br />Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />~2 ~?~ Annual Report <br />C.~A-B-r-E1~'~ u~~ l (~w~~ (AJ 1 /,Lc.~ ,:_y P~~r i-Y-f.a <br /> <br /> <br />Signature <br />