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I ~ <br />rn~~~ <br />;y~ <br />t <br />11~: Enclosure <br />_ ~~1. <br />Permittee Name: Goodell Brothers Inc <br />Permit No: Mal-522- Q{~~<lr ~!]~~ <br />Operation Name: Herman Feit Pit <br />Anniversary Date: 03 / 23 / 85 ( '~ .~~."•.•I r":;~,;i.i~, .,1i; , ~ <br />~, . <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: <br />/qA.~ . ,(.¢a..~ _~lu~~ ox2 uc~te_ ~s-t~ ./ZC.~= lzeo-^J <br />/7-c~iuzr~ b ~a~z <br />~1~~~ <br />Signature <br /> <br /> <br />