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<br /> <br /> <br /> <br />110 Enclosure <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br /> <br />L. Otto Goemmer <br />M-82-129 <br />Goemmer Pit <br />08/05/87 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />C~ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br /> <br />Remarks: <br />nature( ' ~~~ <br />(Rev. 02/87) ~~%~~~ ' <br />5257E <br /> <br />`~i~ .i i~ i, ~ vim! ~, ~,,.r ~~: •-~ ,c~r~ <br />