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~. <br /> <br />• <br />Permit tJo: 82-141 <br />Nnniversary Date: Au ust 9 <br />Operator: <br />~ III IIIIIIIIIIIIIIII <br />~~~E~ <br />!.U C 1 0 1983 <br />MINED LAND RECLAMATIDN <br />Colo. Best. of Natural Reso~rce~ <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(esj) <br />~ Check or money order payaole to Colorado htined Land <br />_ Reclamation Division for annual fees due <br />- Annual Report <br />Remarks: Mr. Butler is out of town but will submit the Annual Report in a <br />few days. <br />Siynature~ A /~ i<3w~) <br />