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• • iii iiiiiiiiiiiu iii <br />110 Encl osg{u~~re <br />Permittee Name: Tezak Construction Company ~~~ ~ " ~® <br />Permit No: M-81-080 May <br />Operation Name: Tezak No 2 Pit 3 ~9~ <br />Anni versary Date: 05/27/88 RECLgMgTDON ND <br />DIVISION <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 />l Annual Report <br />~r~l <br />Signature /J <br />8066G <br />