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<br />. ~~ ~ ~ • ~IIII~I~~!I~II~~~I~ <br />Permittee Name: /~ ~ ~ ~~'~ ~ Gyd~se,n/ <br />~ Permit No: N(_ ~ 7 - ~ Y.~ <br />Operation Name: Go /d L,iiv/fs /v/ ~ //~' <br />Anniversary Date: 7,~3~ ~~~~ <br />_~~ . ~ <br />11 r~nclosure <br />g 1990 <br />~~~ <br />MI~~L' ~~ t~` <br />~tEC.~ a.Mp~'n <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />x Check cr Toney order payable to Colorado i~iined sand Reclamation <br />Division for annual fees due <br />x Annual Report <br /> <br />Signa- <br />~L ~~~ E~ <br />/ ~/ <br />~\~ <br /> <br />Remarks: THI$ IS THE ANNUAL REPORT <br />