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._ ~ ~ II I I II III I II IIII III <br />~. ~ J O(, <br />(~~ 110 Enclosure <br /> <br />Permittee Name: Dilleys Sand & Gravel <br />Permit No: IA-81-004 ~" <br />Operation Name: Ayers Pit <br />Anniversary Date: 02/02/89 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />/ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />/ Annual Report <br />Remarks: <br />onr Tao <br />Signature <br />(Rev, 06/88) <br />0052f <br />