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}.. <br />~ / - S ~ ~ 3 ~ ~~~ ~~~~~~~~~~~~~~~~ <br />Permit No: 0 C/ • ~J ~(~T~ ~/ <br />Anniversary Datee (y-~~/ y <br />Opera ter: <br />Please complete the following and return this form with your fees any <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 />Remarks <br />I};~ I Notice of Intent to Continue Mining Operations <br />Signed, <br />~~/~ /~3 <br />~m_~,~ <br />RECEIVED <br />DEC 121983 <br />MINED LAND RECLAMATION <br />COLO. DEPT. OF NATURAL RESOU'tCES <br />