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~ III IIIIIIIII1111111 ~ <br />~-~` <br />110 and 111 Encl sub re <br />Permittee Name: Berthoud Pink Stone ~K~r.~~~ ~~ <br />Permit No: M-81-057- <br />Operation Name: SPRAGl1E-RED LYONS <br />Anniversary Date: 06 / 10 / 85 ~~L 17 ~;,~; <br />'U11iVE~J L"4n;i~ I,, !~i.AMA IIUN <br />Colo Wept. ei Natural Re:~a:,~rCes <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: ~In ~} Fop ~]- / 0~/~ L/4N~U O/ /~'PNP ,t~ <br />SO /~ P 1^ 1 h hQ.~J ~/ ~ p c R P h~ n y e rl. ~ n L y <br /> <br />