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N <br />N <br />110 and 111 Enclosure <br />4 ;.~ <br />Permittee Name: Farrington Contract <br />Permit No: M-79-034- SAY 21 <br />Operation Name: GARDNER GRAVEL PIT 1986 <br />Anniversary Date: 05 ! 26 J 86 <br />' ~ „d :~~: <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />f Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />`~ Annual Report <br />Remarks: w2 Clr~. <br />~. <br />_. <br />Signature <br />~ <<~, ~~ x z >s <br />~~~~~ (~ i <br />