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<br /> <br />112 Enclosure <br />Permittee Name• Colorado Sand & Gravel Co ~_;,' <br />Permit No: M-80-110- ~ - ``- `.: <br />Operation Name: Henderson Dev <br />Anniversary Date: 09 / 09 / 86 S ~ P 1 G jy8~ <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: See letter of September 12, 1986 <br />X Signature RO • T L EGRIST, MANAGING PARTNER <br />COLORAD SAND &_GRAVEL CO. <br />