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<br />. _ ~'+ III IIIIIIIIIIIIIIII •* <br />~~ <br />110 and 111 Enclosure <br />Permittee Name: GLASS LIVESTOCK CO ~ ~ ,~~y,,,~+' 4~~ <br />Permit No: M-81-(122- <br />Operation Name: GL GRF~VEL PIT )~11 1 7 <br />Anniversary Date: 05 / ~:0 / 85 <br />~E`'L'~1ATION DIDV1~1/`• <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check spice(s) below) <br />t Check or mone~~ order payable to Colorado Mined Land Reclamation <br />Division for ~innual fees due <br />Annual Report <br />Remarks: <br />tr <br />./M <br />~ . <br />ri rrwPl r~r r.~_, ins <br />1440 North Taft Hill Road <br />Signature ~ <br />:~ <br />