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• <br />. 112 Enclosure <br />Permittee Name: Colorado Lien Co <br />Permit No: M-77-301 <br />Operation Name: Roberts Quarry ,~ <br />Anniversary Date: 10 / 27 / 86 ~,, Qr' <br />-~ ,µ~~, <br />Please complete the following and return this form with your f~~it o('T ~ 0 X986 <br />reclamation data. Co~6~~ ~a~C ~gE~~~F,~rf~jf <br />P-'atur-f t~•• <br />4 I~ti~v W~iGi.. <br />Enclosed are: (Check space(s) below) ,. <br />x Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />' x Annual Report <br />Map <br />Remarks: <br />gnature <br />~ J r~Lb ! cad <br />~}'YI .~, <br />~~ <br />