Laserfiche WebLink
<br />~:- <br /> <br />112 Enclosure <br />Permittee Name: Suburban Sand and Gravel <br />Permit No: M-79-195 <br />Operation Name: Road Runners Rest II Pit <br />Anniversary Date: 01/28/89 <br />Please complete the following and return this form with your fees <br />and reclamation data. <br />Enclosed are: Check space(s) below <br />~~ Check or money order payable to Colorado Mined Land Reclama- <br />tion Division for annual fees due <br />~!L Annual Report <br />Map <br />Remarks: <br /> <br /> MINED LAND RECLAMATION DIVISION N 0 O O 9 2 G H <br />1313 Sherman <br /> Denver, Colorado 80203 DaTE ~ - ~ ~ ~ B cY ~/ <br />(303) 8LL6-6-3567 <br />F OM ED ~ U 1'-l~ ~L~LII ~j •+ ~^. $ ~.Jh'. Q_) <br /> ) (~ iL L![', <br />~ yl .'~,_('1~ ~C )~t,"ti: U- ~~~' ti1~~L, ~^~" G`~-------~t7LLAR5- <br /> <br /> (`~1( L~! ~ ^ CASH <br />R ~ PAY B~CkjECK <br />FOR 1Yl.r Y J~1 ~'71 ~~5 ~-l8c'`I ^M.O <br /> . <br /> AMOUNT OF ACCOUNT. .........$ <br />` <br />' <br />A <br />~ ~ <br />l <br /> V IIQ YI <br />` <br />f <br />IA <br />AMOUNT PAID .... ..............$ ~ J~ 1A Y11/ ~ <br />ou <br />BALANCE OUE.. ... $ BY ~1`C' ~ <br /> <br />