Laserfiche WebLink
<br />': <br />• <br />112 Enclosure <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Mathias Concrete Inc <br />M-77-140- <br />N FARM RD PIT NO 1 <br />O1 /15/86 <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 <br />Land Reclamation Division for annual fees due <br />Annual Report <br />Map <br /> <br />~ j' <br />;., '.-- <br />JAN 13 i986 <br />'~"ieiil <br />j / Lb'~t <br />OrA. ~' ~` <br />r-~ <br />Signature <br />