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. _ - ~, iii iiiiiiiiiiiu iii <br />Permittee Name: Charles Devereux <br />Operation Name: <br />Permit No: 78-221 <br />Anniversary Date: August 23 <br />~ ~,~,z2, <br />110 and 111 Attachment <br />RECEIVED <br />AU G 16 1984 <br />MINED LAND RECLAMATION DIVISION <br />Colo. Dept of Natural Resources <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />ICI Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />I_I Annual Report <br />Remarks: ?¢~~i~~ ~~~~r?, ~~#~?~~ <br /> <br />The arc-a used in this nit i.~ ah~ut lAA c~nara fArt.. <br /> <br />Nn R n.nlaimati nn vii ll hn ~il1rP. tai ~ e,P~r_ <br />Signature <br />(Rev. 5/84) <br />Doc. No. 1782 <br /> <br />