REP00010 ‎(3)‎

Permittee Name:
Operation Name:
Permit No:
Anniversary Date
1�
u
John G. Horvath
77 -546
July 26
11
110 and 111 Attachment
Please complete the following and return this form with your fees and
reclamation data.
Enclosed are: (Check box(es))
—� Check or money order payable to Colorado Mined Land
Reclamation Division for annual fees due
I —' Annual Report
Remarks: 9pproxiamtely snn yarria nfoi+ r „n r- „el h-2 h..,,_
---- -�--_— -amevea
from this pit. 911 else remaiiis Vie same as the past year.
oas npR� �een any reclamation work at this time due to the
limited amount of oravel removed.
gnature
(Rev. 5/84)
Doc. No. 1782