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• • III IIIIIIIIIIIIIIII <br /> . 999 <br /> J <br /> 110 and Ill Enclosure <br /> Permittee Name: Nelson Contractors <br /> Permit No: M-78-208- ` ;a�rjr �,4/e-If <br /> Operation Name: SHAFFERS CROSSING h <br /> Anniversary Date: 06 / 16 / 85 JUL i C <br /> pn MI <br /> Please <br /> acomplete <br /> the following and return this form with your feesR dLAMN��AAI() fir, <br /> reclam <br /> tion <br /> Enclosed are: (Check space(s) below) <br /> �C Check or money order payable to Colorado Mined Land Reclamation <br /> Division for annual fees due <br /> Annual Report <br /> Remarks: 177V Luae./(z,y TW-e �SLeJ <br /> Ar <br /> ,(ib 9r<A NaS B1F F. /Y OFcAl i,id <br /> i oh <br /> Si gnat u <br />