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• 112 Enclosure <br />Permittee Name: ELAM CONSTRUCTION CO .. .~ <br />Permit No: M-79-075-HR ~.~„ -• ~,.~.__ <br />Operation Name: CHAMBERS PIT <br />Anniversary Date: 05 / 29 / 85 -•~..,:,,,.i, <br />. ~ ~'tuurrr• <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 : NO YUL 5 f.S t ~ (~ -~ O`L ~L.ftC~ ^T F1 1 S ~~C~(L <br />(~+ "r ~~ Q ~ (7 Q.C ytn,a~2 ~ L-nT o'< <5~~~ PI 1:~~ <br />i'biCl~~! \ ~~ 5 . <br /> <br /> <br />Sibnature <br />