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N ~ III IIIIIIIIIIIIIIII <br />REC~I~E® <br />r ' ~ MAY 101988 110 Enclosure <br />Permittee Name: Indian Springs Minin MINED LAND <br />Permit No: M-•81-0?_0 DECLAMATION DIVISiC?N <br />Operation Name: TFiorsen Mine <br />Anniversary Date: 0'../06/88 <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 payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />~~ Annual Report <br />Remarks: <br /> <br />re <br />8049G <br />