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~. <br />~IV'I~II~IIIII~I III <br />999 ' <br />Permittee Name: ' <br />Permit No: Gold Hi 11 Mining C6 <br />Operation Name: M_g3-141 <br />Anniversary Date: Cash Mine <br />09/07/87 <br />\~g1 <br />n 1. <br />~\ i <br />~c <br />~• <br />110 Enclosure <br />Please complete the following and return this forth with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />f/ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report ~ (~oi,ca.. o'rc Tn~~ ~-o C-0rrl;n.;e. <br />fll ~ n: ny Q~QarE: oc~s <br />Remarks: ~LL Min~nq cLC~-~~:k~es cL+ -F~he. Cash rn:ne h <br />l7es/n Cpn~':necl -Iv i1w>z -~oP eE {he. Mane d~.rnp.~ccR;n~ -titre. <br />~2p~;ou. Tp~ . o~p2ox,rno~4e.1~ brie-hal.4- m~ the h~411-g~Qa~e. <br />15t-ocK.p.~e Loc4~eci on -F~sL wesbe2n -~ht2d o4 i1.~ dump was <br />Sc,2e~r.er~ or~c~ ~+rel~d,. <br />1!~ -1'{~tt L'ixr~: c ULva(1 ~-{{~,~ L'pyh M:nQ. dt.~fhP wiles be. <br />PRo~e.~s~ ;n o. rr.o.~c.ea- {ica~- ,.,:l.J~ Reduce. -}ttiie, S:-ze sF- ~a- <br />du..M ~ ""1 UQp2pX~ rY1Q~e dl1.e - SY 7~{1~. ~~~-5 _.~(ZPSel1 {' ~ : 2e ..~.~ <br />r <br />~ r: ~~ (lo2thwes~- ~f -11~- C-~ {-1:u~ m;~~s -~o,:u~s <br />~onc~ -Ii..cak was n.~eci~d b~.~ -the m:~~s co.~s~a~~;o~ ~.s bees,, <br />C1,eces~~, "`Q. (Ylo~k o~ -tt..o_ downed -E.rnt~e~ cnc~ ct~L of iia` scs><s6. <br />WQ,2S 2l° cbouet~ ~flotn -H~:S ~2~r~n s-~ -N.~ PeFtm:~- 0.~~ . <br />lgnatu`re~~~ ~~ ~_ <br />Rev. 02/87) <br />5257E <br />