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• ~ • ~ III IIIIIIIIIIIIIIII <br />110 and 111 Enclosure <br />Permittee Name: FARRINGTON CONTRACT <br />Permit No: M-79-03A- ~,.r <br />Operation Name: GARDNER GRAVEL PIT <br />Anniversary Date: 05 / 26 / 85 <br />,,, , W iraiu.a: rie;uuiCPS <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 />Remarks: <br /> <br />Signature <br />