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_ . • <br />• ~ 112 Enclosure <br />Permittee Name: <br />Permit No: Delta Sand & Gravel <br />Operation Name: M-77-020- <br />Anniversary Date: PIT NO 1 <br />03/23/86 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />X Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />X Annual Report <br />X Map <br />Remarks: See Attached <br />