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112 Enclosure <br /> Permittee Name: Flatiron Sand & Gravel Co <br /> Permit No: M-81 -302- <br /> Operation Name: DEEPE FARM PIT <br /> Anniversary Date: 06 / 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 /> Check or money order payable to Colorado Mined Land Reclamation <br /> Division for annual fees due <br /> Annual Report <br /> Map <br /> Remarks: /�//(/1 /]O��i��ll e,zzcz! <br /> 4,1 <br /> � o - <br /> JL rnW <br /> CI <br /> Signature <br />