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• 1111111111111111111 • <br />999 <br />110 Enc 1 osur•e <br />. RECEIi/ED <br />Permittee Name: L. Otto Goemmer <br />Permi t No: M-82-129 SF P 1 ~ 1988 <br />Operation Name: Goemmer Pit MINED LAND <br />Anniversary Date: 08/05/88 RECiAMATIONDIVI81pN <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 pdyable to Colorado Muted Land Reclamation <br />Division for annual fees due <br />Annual Report <br /> <br />~~ /~i.r.i J -~ ~ Y,l.~l ~ 1j ~ 7.c~ ~ err ~ <br />.~ <br />(Rev. 06/88) <br />0052f <br />