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1 <br />~' ~ <br />." <br />Permit No: 81-36 <br /> <br />Anniversary Date: April 23 <br />Operator: <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />Check or Honey crder payable to Colorado Mined Land <br />Reclamation Division for annual Fees due <br />Notice of Intent to Continue Mining Operations <br />Remarks <br />~O na i ~I <br />i ~ ~ ^-~ ~~ <br />ti <br />/YG L~~n PRL ~RFM O.[1 rn~~ ~ n_ _ _ <br />,Itu w[cI.~N~a.riury <br />Colo. Dept. of NatnTa t, ,_ <br />T- <br />/~ <br />Signed, //`r_, r7G7_ f/ ~~,y.~/ <br />" / N0. , s7 <br />a.o2_e ~Z 19~ <br />I~ECEIVED FROM ca~~, ~t~ ~,,...~..~ -~ . c~ . <br />~.5c- a •.'o/.oo So .00 <br />DOLLARS <br />T c1_,;,.. 3-e~ ~ 1- 3l0 '-12o iS- MC C~-Y~62Qa.oa <br />'~-p•~o„t ~c ~ Cabo . ~ i -z z ~P <br />_ Account Total $ <br />- Amount Paid $ ~- ~` ~ ~~ ~ ' <br />Balance Due $ ~ " °~~~ <br />'THE EFFiCiENCY~UNE'AN AMVAO PRUUUGT <br />4 ~r 3I8 a <br />