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. ; -r° <br />• <br />111/112 Enclosure <br />Permittee Name: Valco <br />Permit No: M-77-023 f <br />Operation Name: Ready Mix Pit - G unn:sen PST <br />Anniversary Date: O1 / 23 / 87 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />- - Enclosed are: -(C eck space(s) below) <br />'~ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />,v/ Annual Report <br />V Map <br />Remarks: <br />Signature <br />