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~~.::._~....~:.'~L :.., -:.~~ > ~ ~~: `` ~ III IIIIIIIIIIIIIIII ~ ~`` ~. . <br />.. <br />'. - ~ . ~ 111/112 Enclosure <br />- ~ Permittee Name: Cooley GNaveZ R.~~EIVED <br />Permit No: M-74-041 ; <br />Operation Name:' Lcr~rence ~t M.l~R 061987 <br />Anniversary Date: ~ 1/87. MINED LAND <br />. ~ RECLAMA71ON DIVISION <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />r~ ~',~~ <br />Enclosed are: (Check space(s) below) <br />x Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees die <br />~Ac: ~,_ <br />r <br />loR'Tf~ <br />r„ -. <br />i <br />.. O ~ ~ ~ <br />I' <br />~,. <br />,.. <br />.,~ <br />Signature <br />(Rev. 02/87) <br />;• 5257E <br />.v <br />o <br />cA <br />f~ <br />I N <br />147 ~~ <br />3 <br />s <br />.~- ~ <br />.. . +_, <br />ix,~ Annual Report. <br />~.. <br />