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<br /> <br />Permtittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br /> <br />110 Enclosure <br />l~ <br />M. Sims Gravel Company <br />M-87-103 <br />East Douglas Pit <br />08/2 4/88 <br />Plea;:e complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />_~~heck or money order p$yable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />v/ Annual Report <br />Remark s <br />(Rev. 06/88) <br />0052f <br />RECEIVED <br />AU G 101988 <br />MINED LAND <br />nFri AMATIdN DIVISION <br />