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_ - ~ Illlllliiilillll <br />999 III <br />Bentonite Co first <br />Permittee Name: M-77-231- <br />Permit No: Lbc Bentonite Pit <br />Operation Name: 08 / 23 / 86 <br />Anniversary Date: <br />• <br />110 and 111 Enclosure <br />~~~~t~ED <br />AUG 2 01986 <br />MINED LAND RECLAMATION <br />Please complete the following and return this form with your fees an8olo.Dept.olNaturalResources <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: Ann~upG ,Pe~nCy UUE To 7NE Sh~~NE55 <br />e G out n V~L Are vrV ,o r 71 /E PRL sL,v>• 7~ ~r+ ~ ~ bvE Q~ T <br /> <br />i5 eptNre gL~EF, I'95 Fo e Lq.v~ AFF ctYE() f7u~~^~6 G~°sr <br />y6dQ . w E J4+2 f SY-ct ~,JOel' ~ ~. 6 7Hf' fA+n6 AQ EA , <br />7N~S AD_FA i5 /3AC~[~GLL./ uw ~cN.~.y/„ S11 Fp(t aY L EAST ~/YE <br /> <br />LAST• ~ j6'AQ S ~ ANJ 3iVLYiL /1 lbv ri.yUt ~O SU fOLV ot,Q <br />~.a-rE2~.o~ Fe,[ Ati~~ yNBP 5 ~a,P ~ ~ ~ rl,~ a~~ rur,.~ acv <br />~~ct~Lz, ACL ,.~.~~ ~s Ai~ay c yo~uE w.rlt Qf~Law,o~~ory <br />,.y sr+~nrD 7T , s Ac..,oy t A F,~PSr ~P,o~,>v Fob ~s <br />Td I/1LrS> t~Q EYCEEJ yUUle S~RAiAR~ D S Aw~ //fJ(~iTE <br />Signature <br />_//c.`rU <br />l~l~ <br />`~ <br />