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0 0 <br />oii oioo~ooioooooo-o <br />999 <br />112 Enclosure <br />Permittee Name: ~UC ~ ~SSb <br />Permit No: Albert Frei & Sons Inc <br />Operation Name: M-83-033- <br />Anniversary Date: WALSTRUM MINE <br />06/23/86 ' <br /> <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />Check or money order pdyable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />~/ Annual Report <br />~_/ Map <br />Remarks: <br /> <br />wt.I.~~ ~ i •-cu <br />~~~J~ <br />~-~•~` <br />~~ <br />