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. ~ ~ ~ ~ III IIIIIIIIIIIIIIII ~ <br />999 <br /> <br />110 and 111 Enclosure <br />Permittee Name: <br />Permit No: Texas Mng 8 Exp Co <br />Operation Name: M-84-094- <br />Anniversary Date: GLORIA Z MINE <br />07 /17/86 <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 P.eport <br /> <br />Signature <br />