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<br />iii iiniiiiniu iii <br />~.: <br />Permittee Name: DFC Ceramics, Inc. <br />Operation Name: <br />Permit No: 76-7 <br />Anniversary Date: October 4 <br /> <br />110 and 111 Attachment <br />!i..~ r' ~- ~. <br />~ s. <br />tF.lNc LP.tlu P,Lr.~.',:,.-i'~ ? ,1';lSi'Jtl <br />Please complete the following and return this form with your Fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />I I Check or money order payable to Colorado Mined Land <br />Declamation Division for annual fees due <br />I_I Annual Report <br />~ - ~s- g"% <br />Signature <br />(Rev. 5/34) <br />Doc. No. 1782 <br />_.~ <br />~~ <br />,~ <br /> <br />