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MOFFAT COUNTY CLERK AND RECORDER <br />221 W. Victory Way <br />Craig, CO 81625 <br />(970) 824-9104 <br />MINING/ RECLAMATION FORM <br />File Number 067 <br />Drawer Number <br />Return <br />?ma fir. aoo <br />,inn <br />Received <br />Mailing Address <br />Minin9and Reclamation Application for: <br />Name of Pit or mine: 26 <br />Date on which inspection period is over and application may be retrieved by <br />Applicant: <br />Agei <br />For: <br />Attest: County Clerk or Deputy: